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RONKONKOMA PODIATRY CENTER
NPI 1710236856
Podiatrist in Lake Ronkonkoma, NY

Active since September 05, 2012
388 HAWKINS AVE, LAKE RONKONKOMA, NY 11779(631) 585-0045(631) 585-7860 Get Directions Write a Review

NPPES record last updated: September 5, 2012. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ronkonkoma Podiatry Center NPPES

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

RONKONKOMA PODIATRY CENTER (NPI 1710236856) is a healthcare organization registered as a podiatrist in Lake Ronkonkoma, New York and active in the NPI registry since September 2012. The organization lists Mary Palazzo, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1710236856
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameGEORGE D EMMONS DPM PC
Location Address388 HAWKINS AVELake Ronkonkoma, NY 11779-4280
Mailing Address388 Hawkins AveLake Ronkonkoma, NY 11779-4280 · (631) 585-0045 · Fax (631) 585-7860
Phone(631) 585-0045
Fax(631) 585-7860
Organization SubpartNo
Authorized OfficialMary PalazzoOffice Manager · (631) 585-0045
Enumeration DateSeptember 5, 2012
✔ NPI 1710236856 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in NY · 005709
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
388 HAWKINS AVE, Lake Ronkonkoma, NY 11779
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Other Names 1

Doing Business AsRonkonkoma Podiatry Center

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

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ronkonkoma Podiatry Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20121019000683Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Ronkonkoma Podiatry Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

George Emmons, DPM
Podiatry
NPI 1598842577
388 HAWKINS AVE
Lake Ronkonkoma, NY 11779
(631) 585-0045
✔ PECOS✔ Accepts MedicareSame address

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 George D Emmons Dpm PC's NPI number?

The NPI number for George D Emmons Dpm PC is 1710236856. It was assigned to this organization in the NPPES registry on September 5, 2012. The provider is doing business as Ronkonkoma Podiatry Center.

Where is George D Emmons Dpm PC located?

George D Emmons Dpm PC is located at 388 Hawkins Ave, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 585-0045.

What is George D Emmons Dpm PC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is George D Emmons Dpm PC enrolled in Medicare?

Yes. George D Emmons Dpm PC is registered in the Medicare PECOS enrollment system.

When is George D Emmons Dpm PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through George D Emmons Dpm PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to George D Emmons Dpm 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 George D Emmons Dpm PC was last updated on September 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.