John Egdorf

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00392900 Issued in NJ

Practice address

160 Ridge Rd
Lyndhurst, NJ 07071-1275

Phone

(201) 939-9098

NPI assigned

Jul 1, 2022

Reactivated

Jun 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• John Egdorf Professional name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1013640648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711275",
            "telephone_number": "201-939-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711275",
            "telephone_number": "201-939-9098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Clara Maass Dr",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "NJ",
            "postal_code": "071093550",
            "country_code": "US",
            "telephone_number": "973-450-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Pocono Rd",
            "address_purpose": "LOCATION",
            "city": "Denville",
            "state": "NJ",
            "postal_code": "078342954",
            "country_code": "US",
            "telephone_number": "973-625-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070552840",
            "country_code": "US",
            "telephone_number": "973-365-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGDORF",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "deactivation_date": "2023-03-20",
        "reactivation_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00392900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "EGDORF",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Lyndhurst, NJ
• Providers in Lyndhurst, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.