Marc Mitnick, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00109000 Issued in NJ

Practice address

360 Springfield Ave
Summit, NJ 07901-4608

Phone

(908) 522-0761

Fax

(908) 926-2111

NPI assigned

Aug 4, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Podiatry

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlook Medical Center Hospital, Summit, NJ, CCN 310051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Barry J. Gallanter, DPM PA

  dba Bayonne Podiatry Group

  • Foot Surgery Podiatrist
  • Bayonne, NJ
  • NPI 1720149743
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  dba Overlook Hospital

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  Care Compare affiliation

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1356342992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STUART CT",
            "city": "PINE BROOK",
            "state": "NJ",
            "postal_code": "070589646",
            "telephone_number": "973-882-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014608",
            "telephone_number": "908-522-0761",
            "fax_number": "908-926-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITNICK",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00109000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222236123",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittni Kane Alexander Minafra, DO
• Mindful Movements Therapy
• Michael Mira, MD
• Vera Mirashi
• Michael Edward Mirman, PA
• Bethany Cheryl Mitros
• Sarah Behr Moaba, L.C.S.W.
• Michael Mobasser, MD
• Tanay Sanjay Modi, M.B.B.S.
• Morsal N. Mohammadi, APN

• Podiatrist in Summit, NJ
• Providers in Summit, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.