NPIMap

Organization Active NPI

Jack Gold Surgical Appliances, Inc.

  • Prosthetic/Orthotic Supplier
  • Fair Lawn, NJ
National Provider Identifier
1073745535
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
JACK GOLD SURGICAL APPLIANCES, INC.
Practice address
25-09 Broadway
Fair Lawn, NJ 07410-3813
Phone
(201) 444-7750
Fax
(201) 612-1323
NPI assigned
Aug 18, 2009
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Ivan Sabel
Title
Ceo
Phone
(973) 328-3340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

25-09 Broadway
Fair Lawn, NJ 07410-3813

Mailing address

1 Emery Ave
Randolph, NJ 07869-1387
Phone (973) 328-3340

Other identifiers 1

IdentifierTypeStateIssuer
0225321MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930081785 NJ DME Supplier - Certified Orth/Pros/PedorthistDME Supplier - Medical Supply Company With Orthotic-Prosthetic 9830215490 Practice locations: Fair Lawn, NJ

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jack Gold Surgical Appliances, Inc25-09 Broadway, Fair Lawn, NJ 07410-3813(201) 796-3121 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Jack Gold Surgical Appl9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1073745535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMERY AVE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691387",
            "telephone_number": "973-328-3340",
            "fax_number": "973-328-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25-09 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103813",
            "telephone_number": "201-444-7750",
            "fax_number": "201-612-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK GOLD SURGICAL APPLIANCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "SABEL",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-328-3340"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0225321",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.