Organization Active NPI

Associated Foot & Ankle Specialists, LLC

  • Foot & Ankle Surgery Podiatrist
  • Englewood, NJ
National Provider Identifier
1003858598
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD2186 Issued in NJ
Legal business name
ASSOCIATED FOOT & ANKLE SPECIALISTS, LLC
Practice address
370 Grand Ave
Suite 101
Englewood, NJ 07631-4154
Phone
(201) 816-8778
Fax
(201) 816-9009
NPI assigned
Jun 11, 2006
Last updated
Nov 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Authorized official

Name
Barry G Herstik, D.P.MNPI 1467560532
Title
Doctor
Phone
(201) 816-8778

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X MD2186 NJ Primary
Foot Surgery Podiatrist 213ES0131X N004973 NY

Addresses

Primary practice location

370 Grand Ave
Suite 101
Englewood, NJ 07631-4154

Mailing address

370 Grand Ave
Suite 101
Englewood, NJ 07631-4154
Phone (201) 816-8778

Other identifiers 2

IdentifierTypeStateIssuer
01716361MedicaidNY
7994702MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050321000272 NJ Part B Supplier - Clinic/Group Practice 0840245155 Receives reassigned benefits from 3 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1003858598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 GRAND AVE",
            "address_2": "SUITE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314154",
            "telephone_number": "201-816-8778",
            "fax_number": "201-816-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 GRAND AVE",
            "address_2": "SUITE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314154",
            "telephone_number": "201-816-8778",
            "fax_number": "201-816-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FOOT & ANKLE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "HERSTIK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "201-816-8778",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD2186",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N004973",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01716361",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7994702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.