Active NPI
Daniel Witkin
- Podiatrist
- West Orange, NJ
National Provider Identifier
1376997577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 007033
- Practice address
- 72 Conforti Ave
West Orange, NJ 07052-2828 - Phone
- (862) 224-2852
- NPI assigned
- Apr 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Podiatrist | 213E00000X | 007033 | NY | Primary |
Addresses
Primary practice location
72 Conforti Ave
West Orange, NJ 07052-2828
Mailing address
72 Conforti Ave
West Orange, NJ 07052-2828
Phone (862) 224-2852
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190822001631 | NJ | Practitioner - Podiatry | 5395081418 | Practice locations: Wayne, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007033 | NY | MD | Pediatric Occupational Therapist |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1376997577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 CONFORTI AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522828",
"telephone_number": "862-224-2852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 CONFORTI AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522828",
"telephone_number": "862-224-2852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITKIN",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-14",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "007033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.