New Jersey Foot and Ankle Specialists LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00301200 Issued in NJ

Legal business name

NEW JERSEY FOOT AND ANKLE SPECIALISTS LLC

Practice address

1700 Route 23 Ste 160
Wayne, NJ 07470-7513

Phone

(973) 944-0226

Fax

(973) 695-1035

NPI assigned

Mar 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Roberto, D.P.M.NPI 1730417130

Title

Sole Member, Managing Member

Phone

(973) 981-5250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• Theodore Roberto, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Wayne, NJ
  • NPI 1730417130
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Gallagher, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wayne, NJ
  • NPI 1255078713
  Medicare reassignment Care Compare group NPD
• Jason A Wellner, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wayne, NJ
  • NPI 1851910780
  Medicare reassignment NPD

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1508130873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ROUTE 23 STE 160",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707513",
            "telephone_number": "973-944-0226",
            "fax_number": "973-695-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ROUTE 23 STE 160",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707513",
            "telephone_number": "973-944-0226",
            "fax_number": "973-695-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY FOOT AND ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "ROBERTO",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "SOLE MEMBER, MANAGING MEMBER",
        "authorized_official_telephone_number": "973-981-5250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00301200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.