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SOUTH ISLAND PODIATRY SPECIALISTS,PC
NPI 1376607713
Podiatrist - Foot & Ankle Surgery in Medford, NY

Active since December 20, 2006
1641 ROUTE 112, MEDFORD, NY 11763(631) 447-0800(631) 447-0801 Get Directions Write a Review

NPPES record last updated: June 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Island Podiatry Specialists,pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH ISLAND PODIATRY SPECIALISTS,PC (NPI 1376607713) is a healthcare organization registered as a foot & ankle surgery in Medford, New York and active in the NPI registry since December 2006. The organization lists Wayne Joseph Bodamer, President, as its authorized official.

NPPES Registry Identity

NPI1376607713
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameSOUTH ISLAND PODIATRY SPECIALISTS,PC
Location Address1641 ROUTE 112Medford, NY 11763-3635
Mailing Address1641 Route 112Medford, NY 11763-3635 · (631) 447-0800 · Fax (631) 447-0801
Phone(631) 447-0800
Fax(631) 447-0801
Organization SubpartNo
Authorized OfficialWayne Joseph BodamerPresident · (631) 447-0800
Enumeration DateDecember 20, 2006
Last NPPES UpdateJune 13, 2008
✔ NPI 1376607713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in NY · N0-3889
1641 ROUTE 112, Medford, NY 11763
Open in Google Maps ↗

Other Identifiers 2

Medicare PINP0W821NY
Medicare NSC5866630001

Group Practice 1

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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALISON DAWN SILHANEK D.P.M.
Podiatrist (Foot Surgery)
1641 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 447-0800
RACHEL HARTMAN
Counselor (Mental Health)
1641 ROUTE 112
MEDFORD, NY 11763
Suffolk County (631) 291-2385

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 South Island Podiatry Specialists,pc's NPI number?

The NPI number for South Island Podiatry Specialists,pc is 1376607713. It was assigned to this organization in the NPPES registry on December 20, 2006.

Where is South Island Podiatry Specialists,pc located?

South Island Podiatry Specialists,pc is located at 1641 Route 112, Medford, NY 11763. The listed phone number is (631) 447-0800.

What is South Island Podiatry Specialists,pc's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for South Island Podiatry Specialists,pc was last updated on June 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.