Individual provider Active NPI

Michael J. Felicetta

  • Foot Surgery Podiatrist
  • Toms River, NJ
National Provider Identifier
1235191875
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
MD00111300 Issued in NJ
Practice address
1178 Route 37 W
Ste 1
Toms River, NJ 08755-4920
Phone
(732) 240-5677
Fax
(732) 240-0926
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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 MD00111300 NJ Primary

Addresses

Primary practice location

1178 Route 37 W
Ste 1
Toms River, NJ 08755-4920

Mailing address

54 Bey Lea Rd
Ste 1
Toms River, NJ 08753-2978
Phone (732) 505-9728

Other identifiers 1

IdentifierTypeStateIssuer
0990906MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD00111300NJMDFoot Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1235191875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BEY LEA RD",
            "address_2": "STE 1",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532978",
            "telephone_number": "732-505-9728",
            "fax_number": "732-505-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 ROUTE 37 W",
            "address_2": "STE 1",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087554920",
            "telephone_number": "732-240-5677",
            "fax_number": "732-240-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICETTA",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "MD00111300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0990906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.