Organization Active NPI

Island Podiatry PC

  • Podiatric Clinic/Center
  • New Hyde Park, NY
National Provider Identifier
1962467316
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
ISLAND PODIATRY PC
Practice address
1575 Hillside Ave
Ste 104
New Hyde Park, NY 11040-2501
Phone
(516) 775-3544
Fax
(516) 775-3323
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Gary F Stones, DPMNPI 1811965080
Title
VP Treasurer
Phone
(516) 775-3544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

1575 Hillside Ave
Ste 104
New Hyde Park, NY 11040-2501

Mailing address

1575 Hillside Ave
Ste 104
New Hyde Park, NY 11040-2501
Phone (516) 775-3544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930011550 NY DME Supplier - Physician - Podiatry 6709777998 Practice locations: New Hyde Park, NY
O20110430000039 NY Part B Supplier - Clinic/Group Practice 6709777998 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

1575 Hillside Ave
Ste 104
New Hyde Park, NY 11040
Phone (516) 775-3544

Practitioners & affiliated clinicians

Practitioners 1

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1962467316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE",
            "address_2": "STE 104",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-775-3544",
            "fax_number": "516-775-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE",
            "address_2": "STE 104",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-775-3544",
            "fax_number": "516-775-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "STONES",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP TREASURER",
        "authorized_official_telephone_number": "516-775-3544",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.