Organization Active NPI

Kopylenko DPM PC

  • Foot Surgery Podiatrist
  • Manalapan, NJ
National Provider Identifier
1114241387
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
25MD00292700 Issued in NJ
Legal business name
KOPYLENKO DPM PC
Practice address
4 Bridge Plaza Dr Ste 6
Manalapan, NJ 07726
Phone
(732) 823-8769
Fax
(732) 444-5967
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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

Authorized official

Name
Dr. Zinaida V Kopylenko, D.P.M.NPI 1083810717
Title
President/Ceo
Phone
(347) 645-3044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 25MD00292700 NJ Primary

Addresses

Primary practice location

4 Bridge Plaza Dr Ste 6
Manalapan, NJ 07726

Mailing address

24 Forman LN
Manalapan, NJ 07726-2948
Phone (347) 645-3044

Other practice location 1

224 Marc Dr
North Brunswick, NJ 08902-5104
Phone (347) 645-3044

Other practice location 2

224 Marc Dr
North Brunswick, NJ 08902-5104
Phone (347) 645-3044

Other practice location 3

95 Bridge Plaza Dr
Manalapan, NJ 07726
Phone (732) 823-8769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100917000681 NJ Part B Supplier - Clinic/Group Practice 2466577127 Receives reassigned benefits from 1 practitioner
Practice locations: Marlton, NJ; North Brunswick, NJ; Manalapan, NJ; Lawrence Township, NJ; Freehold, NJ; East Brunswick, NJ

National Provider Directory

National Provider Directory

Locations

4 Bridge Plaza Dr
Ste 6
Manalapan, NJ 07726

1412 Stelton Rd
Piscataway, NJ 08854

23 Worlds Fair Dr
Somerset, NJ 08873
Phone (732) 595-5315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548547200000",
    "number": "1114241387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FORMAN LN",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077262948",
            "telephone_number": "347-645-3044",
            "fax_number": "732-851-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BRIDGE PLAZA DR STE 6",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "07726",
            "telephone_number": "732-823-8769",
            "fax_number": "732-444-5967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Marc Dr",
            "address_purpose": "LOCATION",
            "city": "North Brunswick",
            "state": "NJ",
            "postal_code": "089025104",
            "country_code": "US",
            "telephone_number": "347-645-3044",
            "fax_number": "732-851-5566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 Marc Dr",
            "address_purpose": "LOCATION",
            "city": "North Brunswick",
            "state": "NJ",
            "postal_code": "089025104",
            "country_code": "US",
            "telephone_number": "347-645-3044",
            "fax_number": "732-851-5566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 Bridge Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Manalapan",
            "state": "NJ",
            "postal_code": "07726",
            "country_code": "US",
            "telephone_number": "732-823-8769",
            "fax_number": "732-851-5566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOPYLENKO DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2019-01-27",
        "status": "A",
        "authorized_official_last_name": "KOPYLENKO",
        "authorized_official_first_name": "ZINAIDA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "347-645-3044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00292700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; 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.