LONG ISLAND PODIATRY PC
NPI 1063669430
Podiatrist - Primary Podiatric Medicine in Southold, NY
About Long Island Podiatry Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LONG ISLAND PODIATRY PC (NPI 1063669430) is a healthcare organization registered as a primary podiatric medicine in Southold, New York and active in the NPI registry since August 2008. The organization lists Michael Lawrence Brody, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Long Island Podiatry Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Long Island Podiatry PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Long Island Podiatry PC's NPI number?
The NPI number for Long Island Podiatry PC is 1063669430. It was assigned to this organization in the NPPES registry on August 27, 2008.
Where is Long Island Podiatry PC located?
Long Island Podiatry PC is located at 56340 Main Road, Southold, NY 11725. The listed phone number is (631) 765-2772.
What is Long Island Podiatry PC's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Primary Podiatric Medicine, with taxonomy code 213EP1101X.
Is Long Island Podiatry PC enrolled in Medicare?
Yes. Long Island Podiatry PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Long Island Podiatry PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Long Island Podiatry PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Long Island Podiatry PC was last updated on April 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Long Island Podiatry Pc · NPI 1063669430
Primary Podiatric Medicine organization in Southold, New York. Organization record, active in the CMS NPPES registry since August 27, 2008.
## Identity
- **NPI:** 1063669430 (Entity type: Organization)
- **Enumerated:** August 27, 2008
- **Primary specialty:** Podiatrist - Primary Podiatric Medicine · taxonomy 213EP1101X
- **Organization subpart:** No
- **Authorized official:** Michael Brody, PRESIDENT
## Practice location
- **Address:** 56340 MAIN ROAD, Southold, NY 11725-3805
- **Phone:** (631) 765-2772
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 10, 2013
- **Other identifiers:** Medicare NSC 3902290001 (NY); Medicare PIN 3902290001 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1063669430) · Data from the CMS NPPES public registry.