DR. JACK BASTOW (NPI# 1881621423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881621423 |
Entity Type | Individual |
Full Name | DR. JACK BASTOW |
Credential | DPM |
Practice Address |
4 Palisades Dr Suite 250a Albany NY 12205-1443 |
Practice Telephone | 5184581771 |
Practice Fax Number | 5184597682 |
Mailing Telephone | 5184581771 |
Mailing Fax Number | 5184597682 |
Enumeration Date | 2006-06-27 |
Last Update Date | 2009-01-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
003886 | NY | Podiatric Medicine & Surgery Service Providers |
Street Address |
4 PALISADES DR SUITE 250A |
City | ALBANY |
State | NY |
Zip Code | 12205-1443 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205828316 | Ara Kayayan | Internal Medicine | 4 Palisades Dr, Suite 100, Albany, NY 12205-1443 | 2005-08-16 |
1265824478 | Hudson Valley Foot Associates, LLP | Podiatrist | 4 Palisades Dr, Suite 250a, Albany, NY 12205-1449 | 2015-02-25 |
1083031983 | St. Peter's Health Partners Medical Associates, PC | Nurse Practitioner | 4 Palisades Dr, Suite 200a, Albany, NY 12205-1443 | 2014-03-28 |
1922343524 | St Peters Health Partners Medical Associates, PC | Internal Medicine | 4 Palisades Dr, Suite 150, Albany, NY 12205-1443 | 2012-12-07 |
1740525344 | St Peters Health Partners Medical Associates, PC | Internal Medicine | 4 Palisades Dr, Sutie 250, Albany, NY 12205-1443 | 2012-12-07 |
1083834097 | Prime Care Physicians, P.l.l.c. | Internal Medicine | 4 Palisades Dr, Suite 100, Albany, NY 12205-1443 | 2007-05-01 |
1891915807 | Prime Care Physicians, P.l.l.c. | Nurse Practitioner | 4 Palisades Dr, Suite 250, Albany, NY 12205-1443 | 2007-05-01 |
1336260157 | Therese M. Khoury | Physician Assistant | 4 Palisades Dr, Suite 100, Albany, NY 12205-1443 | 2007-04-02 |
1740318237 | Family Medical PC | Family Medicine | 4 Palisades Dr, Suite 130, Albany, NY 12205 | 2007-02-28 |
1770576399 | Joseph Scott Baler | Dermatology | 4 Palisades Dr, Ste 240, Albany, NY 12205-1443 | 2005-08-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518564053 | Capital Regional Rx LLC | Pharmacy | 431 New Karner Road Bldg#4 Suite 180, Albany, NY 12205 | 2020-10-07 |
1548722549 | The Alternative Living Group, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 New Karner Road, Suite 3, Albany, NY 12205 | 2019-04-01 |
1003398439 | Sarah Itwaru | Social Worker | 401 New Karner Road, Albany, NY 12205 | 2018-09-01 |
1740708106 | Kenneth Cook | Physician Assistant | 121everett Rd, Albany, NY 12205 | 2017-09-06 |
1437691839 | Sarah Avery | Physical Therapist | 5 S Family Dr, Colonie, NY 12205 | 2016-11-16 |
1063892776 | Olsen Medical Sales, LLC | Durable Medical Equipment & Medical Supplies | 98 Everett Rd, Albany, NY 12205 | 2015-06-08 |
1972921484 | Alixandra Joy Foisy | Social Worker | 42 Oakwood Dr, Albany, NY 12205 | 2014-04-01 |
1780015206 | The Promptcare Companies | Durable Medical Equipment & Medical Supplies | 1015c Central Avenue, Albany, NY 12205 | 2013-12-09 |
1396088332 | Early Childhood Education Center | Day Training, Developmentally Disabled Services | 251 Washington Ave Extension, Albany, NY 12205 | 2013-03-28 |
1487906707 | Centerfordisabiltyservices | Preferred Provider Organization | 5 Keller Street, Albany, NY 12205 | 2012-10-10 |
Find all providers in zip 12205 |
Taxonomy Code | 213ES0131X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346347432 | Brian Douglas Ashdown | Podiatrist | 2605 Willetta St Sw Ste D2, Albany, OR 97321-3451 | 2006-09-20 |
1225540248 | Mark Brian Friedman, Dpm, Pllc | Podiatrist | 6 Executive Park Dr, Albany, NY 12203-3791 | 2017-10-31 |
1073796967 | Mark Brian Friedman, Dpm, Pllc | Podiatrist | 6 Executive Park Dr, Albany, NY 12203-3791 | 2007-12-13 |
1194736496 | Mark Duane Lentini | Podiatrist | 1971 Western Ave, Albany, NY 12203-5066 | 2006-08-11 |
1114978038 | Capital Region Foot Care Pllc | Podiatrist | 104 Hackett Blvd, Albany, NY 12209-1525 | 2006-05-15 |
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 |
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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.