NPIMap

Organization Active NPI

New Jersey Podiatric Physicians & Surgeons Group LLC

Doing business as Douglas N. DeLorenzo, DPM

  • Podiatrist
  • Kendall Park, NJ
National Provider Identifier
1104641422
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP LLC
Doing business as
Douglas N. DeLorenzo, DPM
Practice address
3228 State Route 27
Kendall Park, NJ 08824-1524
Phone
(732) 297-3002
NPI assigned
Nov 21, 2024
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Cheryl Martinetti
Title
Coo
Phone
(732) 994-5333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

3228 State Route 27
Kendall Park, NJ 08824-1524

Mailing address

4633 Hwy 9
Howell, NJ 07731-3324
Phone (732) 994-5333

Other names 1

  • Douglas N. DeLorenzo, DPM Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250425000860 NJ DME Supplier - Physician - Podiatry 4385870153 Practice locations: Kendall Park, NJ

National Provider Directory

National Provider Directory
Tax ID family
New Jersey Podiatric Physicians and Surgeons Group LLC37 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

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1104641422",
    "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",
            "telephone_number": "732-994-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 STATE ROUTE 27",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241524",
            "telephone_number": "732-297-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "MARTINETTI",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-994-5333"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Douglas N. DeLorenzo, DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kendall Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.