Individual provider Active NPI

Jonathan Edelstien, DPM

  • Podiatrist
  • Wayne, NJ
National Provider Identifier
1205525862
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00391400 Issued in NJ
Practice address
510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone
(973) 925-4111
NPI assigned
May 1, 2023
Last updated
May 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00391400 NJ Primary

Addresses

Primary practice location

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033

Mailing address

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone (973) 925-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260512003864 NJ Practitioner - Podiatry 6901375674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

510 Hamburg Tpke
Suite 108
Wayne, NJ 07470-2025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00391400NJMDPodiatrist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1205525862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSTIEN",
        "first_name": "JONATHAN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00391400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.