Individual provider Active NPI

Zakiyyah Waters, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wayne, NJ
National Provider Identifier
1336675321
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00356300 Issued in NJ
Practice address
510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone
(973) 925-4111
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00356300 NJ Primary

Addresses

Primary practice location

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033

Mailing address

510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone (973) 925-4111

Other practice location 1

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-4891

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
I20200812001585 NJ Practitioner - Podiatry 8022434737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Podiatry Center of New Jersey LLCGroup PAC ID 7719293745, 15 clinicians

Practice addresses (Care Compare)

510 Hamburg Tpke
Suite 108
Wayne, NJ 07470-2033
Phone (718) 431-4979

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions75
Removal of nail tissue74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00356300NJMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Center of New Jersey, LLC Foot & Ankle Surgery CurrentSince Aug 15, 2020 Accepting new patients

Locations

510 Hamburg Tpke
Ste 108
Wayne, NJ 07470
Phone (718) 431-4979

Organizations & group practices 1

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1336675321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 108",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-925-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-4891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ZAKIYYAH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00356300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.