Individual provider Active NPI

Gregg Douglas Rock, DPM

  • Podiatrist
  • Ny, NY
National Provider Identifier
1952415275
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004588 Issued in NY
Practice address
119 West 57TH St
#717
Ny, NY 10019
Phone
(212) 397-3111
Fax
(212) 247-1007
NPI assigned
Aug 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004588 NY Primary
Podiatrist 213E00000X MD2090 NJ

Addresses

Primary practice location

119 West 57TH St
#717
Ny, NY 10019

Mailing address

119 West 57TH St
#717
Ny, NY 10019
Phone (212) 397-3111

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
I20120919000021 NY Practitioner - Podiatry 7517115405 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 W 57 St
New York, NY 10019-2302
Phone (212) 397-3111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD2090NJMDPodiatrist
N004588NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952415275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH ST",
            "address_2": "#717",
            "city": "NY",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-397-3111",
            "fax_number": "212-247-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WEST 57TH ST",
            "address_2": "#717",
            "city": "NY",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-397-3111",
            "fax_number": "212-247-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "GREGG",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004588",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD2090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ny, NY

Sources for this page

Verify at the official NPI Registry.