5 Boro Podiatry PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

5 BORO PODIATRY PC

Practice address

531 Targee St
Staten Island, NY 10304-3501

Phone

(646) 837-5448

Fax

(718) 775-3150

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Sadia ShahNPI 1750518130

Title

Owner

Phone

(917) 613-1629

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Sadia R Shah, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bronx, NY
  • NPI 1750518130
  Medicare reassignment NPD Authorized official
• Daryl Augustine, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Bronx, NY
  • NPI 1164879037
  Medicare reassignment NPD
• Abidur Rahman, DPM

  • Podiatrist
  • Jackson Heights, NY
  • NPI 1225534464
  Medicare reassignment NPD
• Erin Callahan, OTR

  • Occupational Therapist
  • Oyster Bay, NY
  • NPI 1497514822
  NPD (past)
• Dhara Patel, PT

  • Physical Therapist
  • Oyster Bay, NY
  • NPI 1215674304

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1912596271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 WILLIAMSBRIDGE RD APT 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 TARGEE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043501",
            "telephone_number": "646-837-5448",
            "fax_number": "718-775-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 BORO PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SADIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-613-1629"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.