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Jersey Shore Podiatric Associates

Organization Active NPI Foot & Ankle Surgery Podiatrist · Sea Girt, NJ

NPI 1376575993 · NPPES record last updated Jul 29, 2025

Key facts

NPI
1376575993
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
MD2271 (NJ)
Legal business name
JERSEY SHORE PODIATRIC ASSOCIATES
Practice address
2130 Highway 35
BLDG C Ste 312
Sea Girt, NJ 08750-1010
Phone
(732) 974-8200
Fax
(732) 974-0190
NPI assigned
Jul 6, 2006
Organization subpart
No

Authorized official

Name
Dr. Gene S Mirkin, DPM
Title
Owner/President
Phone
(410) 266-7575

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080110000194 NJ Part B Supplier - Clinic/Group Practice 5597845917 Receives reassigned benefits from 4 practitioners
Practice locations: Point Pleasant, NJ; Sea Girt, NJ
O20100930100370 NJ DME Supplier - Physician - Podiatry 5597845917 Practice locations: Sea Girt, NJ

National Provider Directory

Tax ID family
Jersey Shore Podiatric Associates PA (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP		 213ES0103X MD2271 NJ Yes
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2130 Highway 35
BLDG C Ste 312
Sea Girt, NJ 08750-1010

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159
Phone (732) 974-8200

Other practice location 1

2911 Route 88 Ste 3
Point Pleasant Boro, NJ 08742-2871
Phone (732) 892-2100

Other identifiers

IdentifierTypeStateIssuer
1130013MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 29, 2025.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1376575993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "732-974-8200",
            "fax_number": "732-974-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 HIGHWAY 35",
            "address_2": "BLDG C STE 312",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501010",
            "telephone_number": "732-974-8200",
            "fax_number": "732-974-0190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2911 Route 88 Ste 3",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant Boro",
            "state": "NJ",
            "postal_code": "087422871",
            "country_code": "US",
            "telephone_number": "732-892-2100",
            "fax_number": "732-892-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JERSEY SHORE PODIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "MIRKIN",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "410-266-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD2271",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1130013",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Girt, NJ

All providers in Sea Girt, NJ · Foot & Ankle Surgery Podiatrist in New Jersey

Sources for this page

Verify at the official NPI Registry.