Organization Active NPI

Hackensack Quality Foot Care, P.a.

  • Foot & Ankle Surgery Podiatrist
  • Hackensack, NJ
National Provider Identifier
1407943640
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD02077 Issued in NJ
Legal business name
HACKENSACK QUALITY FOOT CARE, P.A.
Practice address
50 Clinton PL
Hackensack, NJ 07601-4579
Phone
(201) 487-4443
Fax
(201) 487-0065
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marc Bozzetti, DPMNPI 1447349451
Title
Partner/Vice President
Phone
(201) 487-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X MD02077 NJ Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X MD001801 NJ

Addresses

Primary practice location

50 Clinton PL
Hackensack, NJ 07601-4579

Mailing address

50 Clinton PL
Hackensack, NJ 07601-4579
Phone (201) 487-4443

Other identifiers 1

IdentifierTypeStateIssuer
6775900MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081218000591 NJ Part B Supplier - Clinic/Group Practice 5496817801 Receives reassigned benefits from 2 practitioners
Practice locations: Hackensack, NJ

National Provider Directory

National Provider Directory

Locations

170 Prospect Ave
Ste 3
Hackensack, NJ 07601
Phone (201) 487-4443

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407943640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CLINTON PL",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014579",
            "telephone_number": "201-487-4443",
            "fax_number": "201-487-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CLINTON PL",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014579",
            "telephone_number": "201-487-4443",
            "fax_number": "201-487-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK QUALITY FOOT CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOZZETTI",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PARTNER/VICE PRESIDENT",
        "authorized_official_telephone_number": "201-487-4443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD02077",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD001801",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6775900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.