Individual provider Active NPI

Daniel J Roche, DPM

  • Podiatrist
  • Edison, NJ
National Provider Identifier
1437181732
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00153800 Issued in NJ
Practice address
4 Progress St
Ste B5
Edison, NJ 08820-1199
Phone
(908) 753-0500
Fax
(908) 753-0199
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00153800 NJ Primary

Addresses

Primary practice location

4 Progress St
Ste B5
Edison, NJ 08820-1199

Mailing address

4 Progress St
Ste B5
Edison, NJ 08820-1199
Phone (908) 753-0500

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
I20100928000928 NJ Practitioner - Podiatry 1557413119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Health Partners CurrentSince Jul 6, 2022 Accepting new patients
Atlantic Health Partners CurrentSince Jul 6, 2022 Accepting new patients
Atlantic Health Partners Podiatrist PastSince Apr 30, 2023 Accepting new patients

Locations

333 US Highway 46
Ste 106
Mountain Lks, NJ 07046
Phone (973) 829-7965

Organizations & group practices 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1437181732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PROGRESS ST",
            "address_2": "STE B5",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201199",
            "telephone_number": "908-753-0500",
            "fax_number": "908-753-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PROGRESS ST",
            "address_2": "STE B5",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201199",
            "telephone_number": "908-753-0500",
            "fax_number": "908-753-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00153800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.