MEDICARE: NYC PODIATRIC MEDICINE AND SURGERY, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N006350	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285949180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYC PODIATRIC MEDICINE AND SURGERY, PC

Provider Business Mailing Address
First Line	:	6456 DIETERLE CRES
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-5027
Country	:	US
Telephone Number	:	718-371-4400
Fax Number	:	718-371-5400

Provider Business Practice Location Address
First Line	:	10914 ASCAN AVE STE 1A
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7804
Country	:	US
Telephone Number	:	718-371-4400
Fax Number	:	718-371-5400

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EVELYN G CAVALIER
Credential	:	DPM
Telephone Number	:	718-371-4400

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	01/12/2026

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