Spa Podiatry, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N004782 Issued in NY

Legal business name

SPA PODIATRY, PC

Doing business as

Malta Foot Specialists

Practice address

3 Hemphill PL Ste 111
Malta, NY 12020-4420

Phone

(518) 899-3338

NPI assigned

Mar 26, 2008

Last updated

May 18, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell Joseph Mongiovi, DPMNPI 1104852136

Title

Secretary/Partner

Phone

(518) 899-3338

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Malta Foot Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Joseph Mongiovi, DPM

  • Sports Medicine Podiatrist
  • Malta, NY
  • NPI 1104852136
  Medicare reassignment Care Compare group NPD Authorized official
• Joyce Marie Senick, DPM

  • Foot Surgery Podiatrist
  • Malta, NY
  • NPI 1710922554
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368835200000",
    "number": "1932371374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HEMPHILL PL STE 111",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204420",
            "telephone_number": "518-899-3338",
            "fax_number": "518-899-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HEMPHILL PL STE 111",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204420",
            "telephone_number": "518-899-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2013-05-18",
        "status": "A",
        "authorized_official_last_name": "MONGIOVI",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "SECRETARY/PARTNER",
        "authorized_official_telephone_number": "518-899-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOYCE M SENICK, DPM",
            "identifier": "RB8171",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RUSSELL J MONGIOVI, DPM",
            "identifier": "RB8170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malta Foot Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichole Seguin, LMHC
• Joyce Marie Senick, DPM
• Eileen Elizabeth Slichko, PHARMD
• Adam Smatko, LMSW
• John Anthony Southworth, LMHC
• St. Peter's Health Partners Medical Associates, P.C.
• Jamie Marie Stahlman, FNP
• Julie Ann Stein, MD
• Kathryn A. Strife, RPH
• Strong Steps Physical Therapy PLLC

• Podiatrist in Malta, NY
• Providers in Malta, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2013; 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.