Northeastern Foot & Ankle Specialists, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00272000 Issued in NJ

Legal business name

NORTHEASTERN FOOT & ANKLE SPECIALISTS, PC

Practice address

235 Main Ave
Passaic, NJ 07055-5501

Phone

(973) 473-6665

Fax

(973) 471-7308

NPI assigned

Nov 17, 2006

Last updated

Jan 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anas Khoury, DPMNPI 1841277571

Title

President

Phone

(973) 473-6665

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anas Khoury, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Passaic, NJ
  • NPI 1841277571
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1265505077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555501",
            "telephone_number": "973-473-6665",
            "fax_number": "973-471-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555501",
            "telephone_number": "973-473-6665",
            "fax_number": "973-471-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN FOOT & ANKLE SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "ANAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-473-6665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00272000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011533",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ian James Nutkis, BCBA
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• Rebecca O'Sullivan, BCBA

• Foot & Ankle Surgery Podiatrist in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.