Organization Active NPI

Foot and Ankle Medical Clinic

  • Foot & Ankle Surgery Podiatrist
  • Clifton, NJ
National Provider Identifier
1497057954
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00303800 Issued in NJ
Legal business name
FOOT AND ANKLE MEDICAL CLINIC
Practice address
520 Clifton Ave
Clifton, NJ 07011-3247
Phone
(973) 272-2525
Fax
(973) 272-3843
NPI assigned
Dec 3, 2010
Last updated
Feb 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Dr. Remon Gendy, DPMNPI 1144480385
Title
Owner
Phone
(973) 907-6210

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 25MD00303800 NJ Primary

Addresses

Primary practice location

520 Clifton Ave
Clifton, NJ 07011-3247

Mailing address

520 Clifton Ave Ste 2
Clifton, NJ 07011-3247
Phone (973) 272-2525

Other identifiers 1

IdentifierTypeStateIssuer
6678840001OtherNJPTAN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110408000049 NJ Part B Supplier - Clinic/Group Practice 9234313685 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ
O20120508000703 NJ DME Supplier - Physician - Podiatry 9234313685 Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

520 Clifton Ave
Clifton, NJ 07011
Phone (973) 340-2400

520 Clifton Ave
Ste 2
Clifton, NJ 07011
Phone (973) 282-2525

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1497057954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CLIFTON AVE STE 2",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113247",
            "telephone_number": "973-272-2525",
            "fax_number": "973-272-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113247",
            "telephone_number": "973-272-2525",
            "fax_number": "973-272-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "GENDY",
        "authorized_official_first_name": "REMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-907-6210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00303800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6678840001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.