Active NPI
Anthony J Enrico, DPM
- Foot & Ankle Surgery Podiatrist
- Paterson, NJ
National Provider Identifier
1013095975
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jan 20, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 25MD00172300
- Practice address
- 628 Broadway
Paterson, NJ 07514-1918 - Phone
- (973) 278-8001
- Fax
- (973) 742-6793
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 25MD00172300 | NJ | Primary |
Addresses
Primary practice location
628 Broadway
Paterson, NJ 07514-1918
Mailing address
628 Broadway
Paterson, NJ 07514-1918
Phone (973) 278-8001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MD00172300 | NJ | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1013095975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 BROADWAY",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075141918",
"telephone_number": "973-278-8001",
"fax_number": "973-742-6793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 BROADWAY",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075141918",
"telephone_number": "973-278-8001",
"fax_number": "973-742-6793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENRICO",
"first_name": "ANTHONY",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NJ",
"license": "25MD00172300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.