Organization Active NPI

Podiatry on Wheels PC

  • Podiatrist
  • Saddle River, NJ
National Provider Identifier
1639055155
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PODIATRY ON WHEELS PC
Practice address
1 Melody LN Uppr
Saddle River, NJ 07458-1857
Phone
(732) 429-0177
NPI assigned
Aug 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
June Park, MD
Title
Ceo
Phone
(732) 429-0177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1 Melody LN Uppr
Saddle River, NJ 07458-1857

Mailing address

1 Melody LN Uppr
Saddle River, NJ 07458-1857
Phone (732) 429-0177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250922003567 NY Part B Supplier - Clinic/Group Practice 0941705958 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1639055155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MELODY LN UPPR",
            "city": "SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581857",
            "telephone_number": "732-429-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MELODY LN UPPR",
            "city": "SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581857",
            "telephone_number": "732-429-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ON WHEELS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JUNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-429-0177",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saddle River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.