Individual provider Active NPI

William M Gutman, D.P.M.

  • Podiatrist
  • Galloway, NJ
National Provider Identifier
1396724324
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00100700 Issued in NJ
Practice address
408 Chris Gaupp Dr Ste 300
Galloway, NJ 08205-4489
Phone
(609) 404-0700
Fax
(609) 404-0712
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00100700 NJ Primary

Addresses

Primary practice location

408 Chris Gaupp Dr Ste 300
Galloway, NJ 08205-4489

Mailing address

750 S White Horse Pike
Hammonton, NJ 08037-2000
Phone (609) 567-0606

Other identifiers 3

IdentifierTypeStateIssuer
0736309MedicaidNJ
7820240001OtherNJDMERC
1396724324OtherNJINDIVIDUAL NPI

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
I20081205000024 NJ Practitioner - Podiatry 9830250158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Center of SJGroup PAC ID 7517397136, 6 clinicians

Practice addresses (Care Compare)

327 W White Horse Pike
Egg Harbor City, NJ 08215-3554
Phone (609) 404-0700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions34
Removal of nail tissue1129
Removal or shaving of skin growth199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00100700NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Center of SJ Podiatrist CurrentSince Jan 5, 2021 Accepting new patients
Stuart W Honick DPM PT LLC Podiatrist CurrentSince Dec 25, 2016 Accepting new patients

Locations

327 W White Horse Pike
Egg Harbor City, NJ 08215
Phone (609) 404-0700

408 Chris Gaupp Dr
Ste 300
Galloway, NJ 08205
Phone (609) 404-0700

750 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 404-0700

199 New Rd
Ste 47
Linwood, NJ 08221
Phone (609) 204-4639

5401 Harding Hwy
Ste 5
Mays Landing, NJ 08330
Phone (609) 625-5400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/32e03c95-b309-4594-826f-8331ad619414/

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1396724324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080372000",
            "telephone_number": "609-567-0606",
            "fax_number": "609-567-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 CHRIS GAUPP DR STE 300",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054489",
            "telephone_number": "609-404-0700",
            "fax_number": "609-404-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00100700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0736309",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "7820240001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1396724324",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.