Individual provider Active NPI

Richard S Pinnock, D.P.M

  • Podiatrist
  • Jamaica, NY
National Provider Identifier
1932232808
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004829 Issued in NY
Practice address
8759 171St St
Jamaica, NY 11432-4554
Phone
(718) 291-4111
Fax
(718) 291-5042
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004829 NY Primary

Addresses

Primary practice location

8759 171St St
Jamaica, NY 11432-4554

Mailing address

8759 171St St
Jamaica, NY 11432-4554
Phone (718) 291-4111

Other identifiers 1

IdentifierTypeStateIssuer
01239665MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000289 NY Practitioner - Podiatry 1951575190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004829NYMDPodiatrist
004829NYMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1932232808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8759 171ST ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324554",
            "telephone_number": "718-291-4111",
            "fax_number": "718-291-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8759 171ST ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324554",
            "telephone_number": "718-291-4111",
            "fax_number": "718-291-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINNOCK",
        "first_name": "RICHARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01239665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.