Individual provider Active NPI

John J Jurcisin, D.P.M

  • Foot Surgery Podiatrist
  • New York, NY
National Provider Identifier
1093811564
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N004398-1 Issued in NY
Practice address
133 E 58TH St
Suite 506
New York, NY 10022-1236
Phone
(212) 750-8344
Fax
(212) 751-1752
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X N004398-1 NY Primary

Addresses

Primary practice location

133 E 58TH St
Suite 506
New York, NY 10022-1236

Mailing address

136 E 56TH St
Apt 2N
New York, NY 10022-3614
Phone (212) 750-8344

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101223000210 NY Practitioner - Podiatry 7517155187 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

133 E 58TH St
Suite 506
New York, NY 10022-1150
Phone (212) 750-8344

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue139
Removal of skin lesions58
Removal of nail tissue902
Removal or shaving of skin growth170
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004398-1NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Precision Foot Care PC Foot Surgery Current Accepting new patients
New Dimension Dentistry Past Accepting new patients

Locations

133 E 58th St
Ste 506
New York, NY 10022
Phone (212) 750-4590

Interoperability endpoints

  • Direct secure messaging: jjurcisin564695@nychhc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1093811564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E 56TH ST",
            "address_2": "APT 2N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223614",
            "telephone_number": "212-750-8344",
            "fax_number": "212-751-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "SUITE 506",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-750-8344",
            "fax_number": "212-751-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURCISIN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N004398-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.