Organization Active NPI

George M. Nassoor, D.P.M., LLC

  • Foot Surgery Podiatrist
  • Phillipsburg, NJ
National Provider Identifier
1548461015
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
MD01279 Issued in NJ
Legal business name
GEORGE M. NASSOOR, D.P.M., LLC
Practice address
430 Memorial Pkwy
Phillipsburg, NJ 08865-1573
Phone
(908) 454-3770
Fax
(908) 454-7822
NPI assigned
May 30, 2007
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Dr. George Michael Nassoor, D.P.M.NPI 1598769267
Title
Podiatrist
Phone
(908) 454-3770

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 Surgery Podiatrist 213ES0131X MD01279 NJ Primary

Addresses

Primary practice location

430 Memorial Pkwy
Phillipsburg, NJ 08865-1573

Mailing address

430 Memorial Pkwy
Phillipsburg, NJ 08865-1573
Phone (908) 454-3770

Other identifiers 2

IdentifierTypeStateIssuer
02698600OtherPACAPITAL BLUE CROSS
2346476000OtherNJAMERIHEALTH

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090717000041 NJ Part B Supplier - Clinic/Group Practice 7012069404 Receives reassigned benefits from 1 practitioner
Practice locations: Phillipsburg, NJ
O20100930060416 NJ DME Supplier - Physician - Podiatry 7012069404 Practice locations: Phillipsburg, NJ

National Provider Directory

National Provider Directory

Locations

430 Memorial Pkwy
Ste 1
Phillipsburg, NJ 08865

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1548461015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MEMORIAL PKWY",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651573",
            "telephone_number": "908-454-3770",
            "fax_number": "908-454-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MEMORIAL PKWY",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651573",
            "telephone_number": "908-454-3770",
            "fax_number": "908-454-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE M. NASSOOR, D.P.M., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "NASSOOR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "908-454-3770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "MD01279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02698600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2346476000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.