Jersey Shore Podiatry ,LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00244300 Issued in NJ

Legal business name

JERSEY SHORE PODIATRY ,LLC

Practice address

600 Mule Rd
Suite 3
Toms River, NJ 08757

Phone

(732) 557-6336

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark E PoplawskiNPI 1629147624

Title

DPM

Phone

(732) 557-6336

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Mark Edward Poplawski, DPM

  • Podiatrist
  • Toms River, NJ
  • NPI 1629147624
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1497969224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MULE ROAD",
            "address_2": "SUITE 3",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MULE RD",
            "address_2": "SUITE 3",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08757",
            "telephone_number": "732-557-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE PODIATRY ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "POPLAWSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "732-557-6336",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00244300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077858",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "P3236068",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jersey Shore Behavioral Therapy LLC
• Jersey Shore Counseling, LLC
• Jersey Shore Medical Associates PC
• Jersey Shore Myofascial Release Center
• Jersey Shore Nutrition
• Jersey Shore Spine LLC
• Jersey Shore Surgery and Vein Center, LLC
• Jersey Spine and Wellness, LLC
• Jeyeye Inc.
• Alyssa Nicole Jimenez, LPC, LCADC

• Podiatrist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.