Organization Active NPI

Sports Foot and Ankle Center PC

  • Podiatric Clinic/Center
  • River Edge, NJ
National Provider Identifier
1477392223
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
SPORTS FOOT AND ANKLE CENTER PC
Practice address
117 Kinderkamack Rd Ste 101
River Edge, NJ 07661-1916
Phone
(347) 251-4497
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Dr. Einul Chowdhury, DPMNPI 1316408099
Title
Owner
Phone
(832) 252-9286

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

117 Kinderkamack Rd Ste 101
River Edge, NJ 07661-1916

Mailing address

63 Howland Ave Apt D
River Edge, NJ 07661-1882

Other practice location 1

63 Howland Ave Apt D
River Edge, NJ 07661-1882
Phone (347) 251-4497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240718004400 NJ Part B Supplier - Clinic/Group Practice 5294271888 Receives reassigned benefits from 1 practitioner
Practice locations: River Edge, NJ
O20250723001702 NJ DME Supplier - Physician - Podiatry 5294271888 Practice locations: River Edge, NJ

National Provider Directory

National Provider Directory

Locations

117 Kinderkamack Rd
Ste 101
River Edge, NJ 07661
Phone (347) 251-4497

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1477392223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 HOWLAND AVE APT D",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KINDERKAMACK RD STE 101",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611916",
            "telephone_number": "347-251-4497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63 Howland Ave Apt D",
            "address_purpose": "LOCATION",
            "city": "River Edge",
            "state": "NJ",
            "postal_code": "076611882",
            "country_code": "US",
            "telephone_number": "347-251-4497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPORTS FOOT AND ANKLE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "CHOWDHURY",
        "authorized_official_first_name": "EINUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-252-9286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Edge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.