Organization Active NPI

Signature Footcare PLLC

  • Podiatrist
  • Great Neck, NY
National Provider Identifier
1992046379
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005686 Issued in NY
Legal business name
SIGNATURE FOOTCARE PLLC
Practice address
35 Franklin PL
Great Neck, NY 11023-1243
Phone
(516) 242-1096
Fax
(509) 272-1096
NPI assigned
Mar 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Rafael Tabari, DPMNPI 1225078553
Title
Podiatrist
Phone
(516) 242-1096

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 N005686 NY Primary

Addresses

Primary practice location

35 Franklin PL
Great Neck, NY 11023-1243

Mailing address

35 Franklin PL
Great Neck, NY 11023-1243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181106000984 NY Part B Supplier - Clinic/Group Practice 1254684434 Receives reassigned benefits from 1 practitioner
Practice locations: Corona, NY

National Provider Directory

National Provider Directory

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": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1992046379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 FRANKLIN PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 FRANKLIN PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231243",
            "telephone_number": "516-242-1096",
            "fax_number": "509-272-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE FOOTCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "TABARI",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "516-242-1096",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.