Individual provider Active NPI

Deborah Marion Siegel

  • Podiatrist
  • Staten Island, NY
National Provider Identifier
1992988364
Registry record updated Dec 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
3330 Issued in NY
Practice address
5656 Amboy Rd
Staten Island, NY 10309-3102
Phone
(718) 967-5884
Fax
(718) 967-1675
NPI assigned
Dec 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 3330 NY Primary

Addresses

Primary practice location

5656 Amboy Rd
Staten Island, NY 10309-3102

Mailing address

5656 Amboy Rd
Staten Island, NY 10309-3102
Phone (718) 967-5884

Other identifiers 1

IdentifierTypeStateIssuer
3330OtherNYDPM LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3330NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1197072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197072000000",
    "number": "1992988364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093102",
            "telephone_number": "718-967-5884",
            "fax_number": "718-967-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093102",
            "telephone_number": "718-967-5884",
            "fax_number": "718-967-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "DEBORAH",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-08",
        "last_updated": "2007-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "3330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPM LICENSE",
            "identifier": "3330",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.