Individual provider Active NPI

Michael John Lasalle, DPM

  • Foot & Ankle Surgery Podiatrist
  • Colts Neck, NJ
National Provider Identifier
1336127620
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD2460 Issued in NJ
Practice address
2 Pegasus Dr
Colts Neck, NJ 07722-1490
Phone
(202) 702-3565
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X MD2460 NJ Primary

Addresses

Primary practice location

2 Pegasus Dr
Colts Neck, NJ 07722-1490

Mailing address

2 Pegasus Dr
Colts Neck, NJ 07722-1490
Phone (202) 702-3565

Other identifiers 1

IdentifierTypeStateIssuer
7915802MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525000861 NJ Practitioner - Podiatry 5799850756 Reassigns benefits to 1 organization
Practice locations: Colts Neck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Forward Podiatry PCGroup PAC ID 3971995697, 29 clinicians

Practice addresses (Care Compare)

1302 Laurel Oak Rd
Voorhees, NJ 08043-4310
Phone (646) 921-0907

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue3250
Removal or shaving of skin growth1257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD2460NJMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Forward Podiatry PC CurrentSince Jan 1, 2024 Accepting new patients
Nymhc FPP Nephrology Past Accepting new patients

Locations

475 Jack Martin Blvd
Brick, NJ 08724
Phone (732) 458-6600

93 Manalapan Ave
Freehold, NJ 07728
Phone (732) 303-8800

65 Jay St
Newark, NJ 07103
Phone (973) 447-8882

303 Elm St
Perth Amboy, NJ 08861
Phone (732) 442-9540

1302 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 346-1200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1336127620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEGASUS DR",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221490",
            "telephone_number": "202-702-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PEGASUS DR",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221490",
            "telephone_number": "202-702-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASALLE",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD2460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7915802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

Verify at the official NPI Registry.