Johns Orthopedic & Shoe Repair LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

JOHNS ORTHOPEDIC & SHOE REPAIR LLC

Practice address

929 Broadway
Bayonne, NJ 07002-3050

Phone

(201) 339-8750

Fax

(201) 455-2606

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John T Urrutia, C. PED.

Title

Sole MBR/Owner

Phone

(201) 339-8750

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1316099310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023050",
            "telephone_number": "201-339-8750",
            "fax_number": "201-455-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023050",
            "telephone_number": "201-339-8750",
            "fax_number": "201-455-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS ORTHOPEDIC & SHOE REPAIR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "URRUTIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MBR/OWNER",
        "authorized_official_telephone_number": "201-339-8750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C. PED."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8087202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rosa D Jones, LCSW
• Ruth Jones, OD
• Shera Jones
• Jordan M. Alter, D.D.S.
• Zamara Joseph

• Customized Equipment (DME) in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.