NEW ENGLAND PODIATRY ASSOCIATES, P.C. NPI 1003010273

Podiatrist (Foot & Ankle Surgery) in Waltham, MA

About NEW ENGLAND PODIATRY ASSOCIATES, P.C.

New England Podiatry Associates, P.c. is a provider in Waltham, MA. The NPI number assigned to this provider is 1003010273. The practitioner's primary taxonomy code is Podiatrist (213ES0103X). The provider is registered as an organization and their NPI record was last updated 6 years ago. New England Podiatry Associates, P.c. operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

NPI1003010273 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameNEW ENGLAND PODIATRY ASSOCIATES, P.C.
Provider Location Address669 MAIN ST WALTHAM, MA 02451 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address669 MAIN ST WALTHAM, MA 02451 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date06-12-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-15-2011 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

NEW ENGLAND PODIATRY ASSOCIATES, P.C.
669 MAIN ST
WALTHAM, MA
ZIP 02451
Phone: (781) 891-3311
Fax: (781) 891-1315
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Mailing Address

NEW ENGLAND PODIATRY ASSOCIATES, P.C.
669 MAIN ST
WALTHAM, MA
ZIP 02451
Phone: (781) 891-3311
Fax: (781) 891-1315

Primary Taxonomy

Taxonomy Code213ES0103X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
SpecializationFoot & Ankle Surgery
License No.1948
License StateMA

Authorized Official

Authorized Official NameDR. RONALD BRIAN ETSKOVITZ D.P.M. Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePODIATRIST
Authorized Official Phone(781) 891-3311

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
Y77080MEDICARE ID-TYPE UNSPECIFIED (04)MA
9740333MEDICAID (05)MA

Map Location


NEW ENGLAND PODIATRY ASSOCIATES, P.C. address is 669 MAIN ST WALTHAM, MA 02451