Organization Active NPI

Foot Care of Livingston PC

  • Podiatrist
  • Livingston, NJ
National Provider Identifier
1003024563
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD01408 Issued in NJ
Legal business name
FOOT CARE OF LIVINGSTON PC
Practice address
349 E Northfield Rd
Lower Level 6
Livingston, NJ 07039-4802
Phone
(973) 992-9214
Fax
(973) 992-4625
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly Ann OliverosNPI 1285855015
Title
Owner
Phone
(973) 992-9214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X MD01408 NJ Primary

Addresses

Primary practice location

349 E Northfield Rd
Lower Level 6
Livingston, NJ 07039-4802

Mailing address

349 East Northfield Road
Lower Level 6
Livingston, NJ 07039-4671
Phone (973) 992-9214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000068 NJ Part B Supplier - Clinic/Group Practice 3779681895 Receives reassigned benefits from 1 practitioner
Practice locations: Livingston, NJ

National Provider Directory

National Provider Directory

Locations

776 Amboy Ave
Ste 201
Edison, NJ 08837
Phone (732) 661-0030

349 E Northfield Rd
Lowr
Livingston, NJ 07039
Phone (973) 251-2874

349 E Northfield Rd
#6
Livingston, NJ 07039
Phone (732) 738-6100

349 E Northfield Rd
Ste LL6
Livingston, NJ 07039
Phone (732) 248-2174

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1003024563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 EAST NORTHFIELD ROAD",
            "address_2": "LOWER LEVEL 6",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394671",
            "telephone_number": "973-992-9214",
            "fax_number": "973-992-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E NORTHFIELD RD",
            "address_2": "LOWER LEVEL 6",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394802",
            "telephone_number": "973-992-9214",
            "fax_number": "973-992-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT CARE OF LIVINGSTON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "OLIVEROS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-992-9214"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD01408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.