Organization Active NPI

Michael J. Brunetti, D.P.M., P.C.

  • Podiatrist
  • New York, NY
National Provider Identifier
1902113392
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005063-1 Issued in NY
Legal business name
MICHAEL J. BRUNETTI, D.P.M., P.C.
Practice address
305 E 86TH St
Suite 1GW
New York, NY 10028-4702
Phone
(212) 534-9393
Fax
(212) 534-9397
NPI assigned
Sep 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Peter J. McKinnon
Title
Billing Manager
Phone
(914) 244-9530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N005063-1 NY Primary

Addresses

Primary practice location

305 E 86TH St
Suite 1GW
New York, NY 10028-4702

Mailing address

423 E 75TH St
New York, NY 10021-3119
Phone (212) 534-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101008000320 NY Part B Supplier - Clinic/Group Practice 5597957555 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

423 E 75th St
New York, NY 10021
Phone (212) 241-3699

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1902113392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 E 75TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213119",
            "telephone_number": "212-534-9393",
            "fax_number": "212-534-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 86TH ST",
            "address_2": "SUITE 1GW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100284702",
            "telephone_number": "212-534-9393",
            "fax_number": "212-534-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. BRUNETTI, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "MCKINNON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-244-9530",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005063-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.