NPIMap

Organization Active NPI

New Jersey Podiatric Physicians & Surgeons Group LLC

  • Podiatrist
  • Edison, NJ
National Provider Identifier
1093393217
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP LLC
Practice address
1672 State Route 27 FL 1
Edison, NJ 08817-3596
Phone
(732) 253-7957
Fax
(732) 510-0698
NPI assigned
Mar 30, 2021
Last updated
Mar 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Cheryl Martinetti
Title
Chief Operating Officer
Phone
(732) 994-5333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

1672 State Route 27 FL 1
Edison, NJ 08817-3596

Mailing address

4633 Hwy 9
Howell, NJ 07731-3324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211111000576 NJ DME Supplier - Physician - Podiatry 4385870153 Practice locations: Edison, NJ

National Provider Directory

National Provider Directory
Tax ID family
NJ Podiatric Phys Srgns GR37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

1672 State Route 27
Fl 1
Edison, NJ 08817
Phone (732) 253-7957

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1093393217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 HWY 9",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077313324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 STATE ROUTE 27 FL 1",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173596",
            "telephone_number": "732-253-7957",
            "fax_number": "732-510-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "MARTINETTI",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "732-994-5333"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.