Organization Active NPI

Comprehensive Foot and Ankle Care, LLC

  • Podiatric Clinic/Center
  • Mountainside, NJ
National Provider Identifier
1609544246
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
COMPREHENSIVE FOOT AND ANKLE CARE, LLC
Practice address
1156 Springfield Ave
Mountainside, NJ 07092-2906
Phone
(908) 793-8454
Fax
(908) 325-0040
NPI assigned
Aug 30, 2021
Last updated
Dec 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

Authorized official

Name
Dr. Mireille Blanchette, DPM
Title
Podiatrist / Manager
Phone
(908) 793-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

1156 Springfield Ave
Mountainside, NJ 07092-2906

Mailing address

1156 Springfield Ave
Mountainside, NJ 07092-2906
Phone (908) 793-8454

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211109000893 NJ Part B Supplier - Clinic/Group Practice 9234528407 Receives reassigned benefits from 1 practitioner
Practice locations: Mountainside, NJ
O20220504000580 NJ DME Supplier - Physician - Podiatry 9234528407 Practice locations: Mountainside, NJ

National Provider Directory

National Provider Directory

Locations

1156 Springfield Ave
Mountainside, NJ 07092
Phone (908) 232-0995

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": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640908800000",
    "number": "1609544246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 SPRINGFIELD AVE",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922906",
            "telephone_number": "908-793-8454",
            "fax_number": "908-325-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 SPRINGFIELD AVE",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922906",
            "telephone_number": "908-793-8454",
            "fax_number": "908-325-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE FOOT AND ANKLE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A",
        "authorized_official_last_name": "BLANCHETTE",
        "authorized_official_first_name": "MIREILLE",
        "authorized_official_title_or_position": "PODIATRIST / MANAGER",
        "authorized_official_telephone_number": "908-793-8454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; 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.