SOUTH SHORE PODIATRY, PLLC (NPI# 1457735094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457735094 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE PODIATRY, PLLC |
| Practice Address |
20 Hicksville Rd Suite 2 Massapequa NY 11758-5819 |
| Practice Telephone | 5167440354 |
| Practice Fax Number | 8559591613 |
| Mailing Telephone | 5167440354 |
| Mailing Fax Number | 8559591613 |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2016-03-14 |
| Authorized Official Name | DR. MITAL B PATEL (PODIATRIST) |
| Authorized Official Telephone | 5165907744 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
N006053-1 | NY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02669029 | 05 | |
| NY | MEDICARE | PK6781 | 01 |
| NY | MEDICARE PTAN | A100127791 | 01 |
| Street Address |
20 HICKSVILLE RD SUITE 2 |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758-5819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053343871 | Mital B. Patel | Podiatrist | 20 Hicksville Rd, Massapequa, NY 11758-5819 | 2006-07-06 |
| 1952812406 | Alyse Kathleen Middenorf | Social Worker | 20 Hicksville Rd, Massapequa, NY 11758-5819 | 2017-10-23 |
| 1972956332 | Lock and Key Therpay, Lcsw, Pllc | Social Worker | 20 Hicksville Rd, Suite 5, Massapequa, NY 11758-5819 | 2016-07-20 |
| 1619325032 | Winthrop Community Medical Affiliates, P.C. | Urology | 20 Hicksville Rd, Suite 3, Massapequa, NY 11758-5819 | 2016-05-26 |
| 1083955660 | Katherine Ann Carroll | Physician Assistant | 20 Hicksville Rd, Suite 2, Massapequa, NY 11758-5819 | 2013-03-07 |
| 1023393493 | Robert Mucciolo Md PC | Urology | 20 Hicksville Rd, Suite 3, Massapequa, NY 11758-5819 | 2011-10-18 |
| 1720253487 | Marjorie J Isdith Do PC | Family Medicine | 20 Hicksville Rd, Suite 5, Massapequa, NY 11758-5819 | 2008-04-24 |
| 1952587891 | Jennie Lee Faraci | Social Worker | 20 Hicksville Rd, Suite 5, Massapequa, NY 11758-5819 | 2008-01-10 |
| 1003940248 | Peconic Urology P.C. | Urology | 20 Hicksville Rd, Suite 3, Massapequa, NY 11758-5819 | 2007-03-16 |
| 1245334473 | Robert L Mucciolo | Urology | 20 Hicksville Rd, Suite 3, Massapequa, NY 11758-5819 | 2006-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535339 | Jamie Leigh Disilvio | Licensed Practical Nurse | 24 Amity Pl., Massapequa, NY 11758 | 2019-12-16 |
| 1548787955 | June H Friedman | Social Worker | 78 North Pine Street, North Massapequa, NY 11758 | 2017-08-25 |
| 1376078568 | Caitlin Bree Kennedy | Acupuncturist | 507 Hicksville Road, Massapequa, NY 11758 | 2017-04-25 |
| 1932645561 | Maria Amato | Specialist | 277 Division Ave, Massapequa, NY 11758 | 2017-01-06 |
| 1164877270 | Marylou Lawson | Early Intervention Provider Agency | 87 N Pine Street, N Massapequa, NY 11758 | 2016-04-26 |
| 1417314196 | Tender Heart Senior Care Corp | In Home Supportive Care | 24 Peconic Dr, Massapequa, NY 11758 | 2016-01-26 |
| 1316328420 | Theresa Mackey | Behavioral Analyst | 19 Oxford Avenue, N. Massapequa, NY 11758 | 2015-06-15 |
| 1932596590 | Bianca Ferrantelli | Specialist | 13 Alhabra Rd, Apt 5, Massapequa, NY 11758 | 2015-04-22 |
| 1245625797 | Medwell Medical PC | Pain Medicine | 1065a North Broadway, Massapequa, NY 11758 | 2015-04-01 |
| 1053703926 | Joseph Sgaglione | Physical Therapist | 503 Wright Drive, Massapequa, NY 11758 | 2015-03-02 |
| Find all providers in zip 11758 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174614630 | Michael L Tumen | Podiatrist | 4333 Merrick Rd, Massapequa, NY 11758-6001 | 2006-09-27 |
| 1922036466 | Corey Fox | Podiatrist | 4160 Merrick Rd, Massapequa, NY 11758-6000 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159756 | West Side Foot Group, L.l.p. | Podiatrist | 244 W 54th St Fl 10, New York, NY 10019-5597 | 2020-09-21 |
| 1740815836 | Ernest L Isaacson Dpm PC | Podiatrist | 4 Technology Dr Ste 110, East Setauket, NY 11733-4068 | 2020-03-09 |
| 1619502242 | Westhampton Beach Podiatry P.C. | Podiatrist | 70 C Old Riverhead Road, Westhampton Beach, NY 11978 | 2020-03-04 |
| 1568025641 | Afsana Qader, Dpm P.c | Podiatrist | 182 Martine Ave, White Plains, NY 10601-3305 | 2019-04-15 |
| 1396233664 | Dr. Mariola Rivera Podiatry, Pllc | Podiatrist | 10 Mitchell Pl Ste 105, White Plains, NY 10601-4300 | 2018-04-23 |
| 1457856403 | Bgy Podiatry PC | Podiatrist | 9810 64th Ave Apt Gb, Rego Park, NY 11374-2501 | 2018-03-29 |
| 1184135568 | Active Podiatry Pllc | Podiatrist | 149 Marine Ave Apt La, Brooklyn, NY 11209-7712 | 2017-10-12 |
| 1730623869 | Westside Podiatry Group | Podiatrist | 507 Beahan Rd, Rochester, NY 14624-3403 | 2016-12-08 |
| 1386191203 | Comprehensive Podiatric Foot Care Pllc | Podiatrist | 88-34 161th Street, Jamaica, NY 11432-4040 | 2016-09-08 |
| 1104277185 | Zhi Q Huang | Podiatrist | 2130 E 24th St, First Floor, Brooklyn, NY 11229-4902 | 2016-06-30 |
| Find all providers with the same taxonomy | ||||
| City | MASSAPEQUA |
| Zip Code | 11758 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.