Organization Active NPI

Foot & Ankle Surgical Associates LLP

  • Foot & Ankle Surgery Podiatrist
  • Englewood, NJ
National Provider Identifier
1265726830
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD00304200 Issued in NJ
Legal business name
FOOT & ANKLE SURGICAL ASSOCIATES LLP
Practice address
54 S Dean Street
Englewood, NJ 07631
Phone
(718) 728-3334
Fax
(718) 777-3180
NPI assigned
Jun 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Dr. Gianni Persich, DPM
Title
Managing Partner
Phone
(718) 728-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X MD00304200 NJ Primary

Addresses

Primary practice location

54 S Dean Street
Englewood, NJ 07631

Mailing address

54 S Dean Street
Englewood, NJ 07631
Phone (718) 728-3334

Other identifiers 1

IdentifierTypeStateIssuer
01360874MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1265726830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 S DEAN STREET",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "718-728-3334",
            "fax_number": "718-777-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 S DEAN STREET",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "718-728-3334",
            "fax_number": "718-777-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SURGICAL ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "PERSICH",
        "authorized_official_first_name": "GIANNI",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "718-728-3334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD00304200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01360874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.