Individual provider Active NPI

Kenneth Eugene Coombs, DPM

  • Podiatrist
  • Smithtown, NY
National Provider Identifier
1992706287
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
NOO 37201-1 Issued in NY
Practice address
154 Terry Rd
Smithtown, NY 11787-5103
Phone
(631) 724-8285
Fax
(631) 724-1598
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NOO 37201-1 NY Primary
Podiatrist 213E00000X 518-025 WI

Addresses

Primary practice location

154 Terry Rd
Smithtown, NY 11787-5103

Mailing address

154 Terry Rd
Smithtown, NY 11787-5103
Phone (631) 724-8285

Other identifiers 1

IdentifierTypeStateIssuer
011725369MedicaidNY

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
I20111007000007 NY Practitioner - Podiatry 9739290586 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvey a Freedman DPM PCGroup PAC ID 6305957192, 2 clinicians

Practice addresses (Care Compare)

276 Smithtown Blvd
Nesconset, NY 11767-2084
Phone (631) 724-8285

Merit-based Incentive Payment System (MIPS)

Final score
98.94 of 100Reported as individual
Quality
77.87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue82
Removal of skin lesions25
Removal of nail tissue501
Removal or shaving of skin growth402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NOO 37201-1NYMDPodiatrist
518-025WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Northeast, LLC CurrentSince Mar 1, 2024 Accepting new patients
Harvey a Freedman DPM PC Podiatrist Current Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Harvey a Freedman DPM PC Podiatrist CurrentSince Mar 17, 1990 Accepting new patients
NV Pacs 2 LLC CurrentSince Jul 1, 2021 Accepting new patients
Hospitalist Healthcare Services PLLC Current Accepting new patients
New York General Medical Services PC CurrentSince Dec 1, 2017 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3530 Wayne Ave
Bronx, NY 10467
Phone (718) 655-1700

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

4241 201st St
Flushing, NY 11361
Phone (516) 599-5688

2090 Albany Post Rd
Montrose, NY 10548
Phone (914) 788-6003

276 Smithtown Blvd
Ste 1
Nesconset, NY 11767
Phone (631) 724-8285

276 Smithtown Blvd
Nesconset, NY 11767
Phone (631) 467-7600

17850 Linden Blvd
Rochdale Village, NY 11434
Phone (718) 990-0300

1 Elsie St
Rome, NY 13440
Phone (315) 336-4435

101 Elm St
Sayville, NY 11782
Phone (631) 244-2400

154 Terry Rd
Smithtown, NY 11787
Phone (631) 724-4220

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Interoperability endpoints

  • Direct secure messaging: kcoombs@hafdp-ny.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1992706287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875103",
            "telephone_number": "631-724-8285",
            "fax_number": "631-724-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875103",
            "telephone_number": "631-724-8285",
            "fax_number": "631-724-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "NOO 37201-1",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "518-025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011725369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.