NPIMap

Organization Active NPI

Lyncourt Footcare PC

  • Podiatrist
  • Syracuse, NY
National Provider Identifier
1972787026
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004816 Issued in NY
Legal business name
LYNCOURT FOOTCARE PC
Practice address
792 North Main Street
Syracuse, NY 13212-1660
Phone
(315) 452-4670
Fax
(315) 579-4670
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Dr. Douglas J Dickson, DPMNPI 1083649008
Title
Owner
Phone
(315) 452-4670

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N004816 NY Primary

Addresses

Primary practice location

792 North Main Street
Syracuse, NY 13212-1660

Mailing address

792 North Main Street
Syracuse, NY 13212-1660
Phone (315) 452-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100217000323 NY Part B Supplier - Clinic/Group Practice 1557405347 Receives reassigned benefits from 1 practitioner
Practice locations: Fulton, NY

National Provider Directory

National Provider Directory

Locations

522 S 4th St
Ste 400
Fulton, NY 13069
Phone (315) 452-4670

Practitioners & affiliated clinicians

Practitioners 8

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": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1972787026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 NORTH MAIN STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132121660",
            "telephone_number": "315-452-4670",
            "fax_number": "315-579-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 NORTH MAIN STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132121660",
            "telephone_number": "315-452-4670",
            "fax_number": "315-579-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNCOURT FOOTCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-452-4670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.