Jennifer Kmieczak, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

MD02491 Issued in NJ

Practice address

142 Engle St
Englewood, NJ 07631-2507

Phone

(201) 568-0033

Fax

(201) 568-3453

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkmieczakmizrachy53785@epicdirect.rwjbh.org

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.

• Hillsborough Podiatry Group, LLC

  • Primary Podiatric Medicine Podiatrist
  • Hillsborough, NJ
  • NPI 1700029048
  Medicare reassignment NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1497798953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-568-0033",
            "fax_number": "201-568-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-568-0033",
            "fax_number": "201-568-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMIECZAK",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD02491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8151105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Klein, MD
• Anna Marie Kleiner, LCSW
• Lilly Kliman, LCSW
• Gary Klingsberg, D.O.
• Akiva Klitsner
• James Ko
• Michelle Theresa Koch, FNP
• Jeffrey Kocher, MD
• Beverly Anne Kolsky, MSW, LCSW, BCD-P.
• Srikant Kondapaneni, MD

• Podiatrist in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.