Noah Stark, DPM
Individual provider Active NPI Podiatrist · Roselle Park, NJ
NPI 1508302076 · NPPES record last updated Jan 27, 2019
Key facts
- NPI
- 1508302076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- 25MD00340400 (NJ)
- Practice address
- 318 Chestnut St
Roselle Park, NJ 07204 - Phone
- (908) 687-5757
- NPI assigned
- Jan 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthdrive Podiatry Group PC
Practice addresses (Care Compare)
103 Carnegie Ctr
Suite 300
Princeton, NJ 08540-6235
Phone (888) 964-6681
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 4183 |
| Removal or shaving of skin growth | 250 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190219000344 | NJ | Practitioner - Podiatry | 6800134735 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MD00340400 | NJ | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthdrive Podiatry Group, PC | Podiatrist | Current |
Accepting new patients |
| Noah Stark, DPM LLC | Podiatrist | Current | Accepting new patients |
| Healthdrive Podiatry Group, PC | Podiatrist | Current |
Accepting new patients |
| Skybridge Healthcare Limited Liability Company | Past | Accepting new patients | |
| Foot and Ankle Center of New Jersey LLC | Past | Accepting new patients |
Locations
100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486
103 Carnegie Ctr
Ste 300
Princeton, NJ 08540
Phone (609) 524-2514
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 25MD00340400 | NJ | Yes |
Addresses
Primary practice location
318 Chestnut St
Roselle Park, NJ 07204
Mailing address
1034 Clinton St
Apartment 410
Hoboken, NJ 07030-3133
Phone (973) 699-6360
Other practice location 1
225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5000
Other practice location 2
70 Hudson St Bsmt
Hoboken, NJ 07030-5630
Phone (201) 659-5222
Other practice location 3
1034 Clinton St
Apartment 410
Hoboken, NJ 07030
Phone (973) 699-6360
Other practice location 4
4491 Route 27
Princeton, NJ 08540-8708
Phone (609) 924-8663
Other providers in Roselle Park, NJ
- Alexa Smith
- David Andrew Snyder
- Robert B Solomon
- Sonal Jain,D.D.S.,P.a.
- Kristin M Sonneborn
- Strength Physical Therapy LLC
- Maureen F Sweeney-McDonough
- Kimberly Tate
- The New Center Inc.
- Reena J Thoonkuzhy
All providers in Roselle Park, NJ · Podiatrist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.