NPIMap

Organization Active NPI

NJ Minimally Invasive Podiatric Surgery P.C.

  • Foot & Ankle Surgery Podiatrist
  • Nazareth, PA
National Provider Identifier
1285369272
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
NJ MINIMALLY INVASIVE PODIATRIC SURGERY P.C.
Doing business as
NJ Minimally Invasive Podiatric Surgery P.C.
Practice address
173 Kingsbury CT
Nazareth, PA 18064-1147
Phone
(201) 701-1595
Fax
(212) 867-3845
NPI assigned
Jul 22, 2022
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Jose Eligio Grullon Jr., DPMNPI 1750842811
Title
Podiatrist
Phone
(201) 598-1184

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
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

173 Kingsbury CT
Nazareth, PA 18064-1147

Mailing address

173 Kingsbury CT
Nazareth, PA 18064-1147
Phone (201) 598-1184

Other names 1

  • NJ Minimally Invasive Podiatric Surgery P.C. Doing business as

National Provider Directory

National Provider Directory

Locations

1250 E Ridgewood Ave
Ste 11
Ridgewood, NJ 07450
Phone (201) 689-1900

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1285369272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 KINGSBURY CT",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180641147",
            "telephone_number": "201-598-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 KINGSBURY CT",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180641147",
            "telephone_number": "201-701-1595",
            "fax_number": "212-867-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ MINIMALLY INVASIVE PODIATRIC SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "GRULLON",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ELIGIO",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "201-598-1184",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NJ Minimally Invasive Podiatric Surgery P.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NJ Minimally Invasive Podiatric Surgery P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nazareth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.