Organization Active NPI

Jsy Englewood Foot & Ankle Center PC

  • Primary Podiatric Medicine Podiatrist
  • Englewood, NJ
National Provider Identifier
1275810343
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
JSY ENGLEWOOD FOOT & ANKLE CENTER PC
Practice address
15 Engle St Ste 202
Englewood, NJ 07631-2920
Phone
(201) 227-0900
Fax
(201) 227-0903
NPI assigned
Nov 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Yoon O Han, DPMNPI 1801050778
Title
Owner
Phone
(201) 227-0900

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
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X Primary

Addresses

Primary practice location

15 Engle St Ste 202
Englewood, NJ 07631-2920

Mailing address

15 Engle St Ste 202
Englewood, NJ 07631-2920
Phone (201) 227-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120106000114 NJ Part B Supplier - Clinic/Group Practice 8426224890 Receives reassigned benefits from 1 practitioner
Practice locations: Englewood, NJ
O20120322000637 NJ DME Supplier - Physician - Podiatry 8426224890 Practice locations: Englewood, NJ
O20160329001210 NY Part B Supplier - Clinic/Group Practice 8426224890 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

185 Engle St
Ste 200
Englewood, NJ 07631
Phone (201) 227-0700

185 Engle St
Ste 202
Englewood, NJ 07631

15 Engle St
Ste 202
Englewood, NJ 07631
Phone (201) 227-0700

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": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1275810343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENGLE ST STE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312920",
            "telephone_number": "201-227-0900",
            "fax_number": "201-227-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENGLE ST STE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312920",
            "telephone_number": "201-227-0900",
            "fax_number": "201-227-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSY ENGLEWOOD FOOT & ANKLE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "YOON",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-227-0900",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 3, 2011; 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.