Active NPI
Philip J Cynamon, DPM
- Podiatrist
- Wayne, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 25MD00380000
- Practice address
- 510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033 - Phone
- (973) 925-4111
- Fax
- (973) 925-7711
- NPI assigned
- Apr 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Podiatrist | 213E00000X | 25MD00380000 | NJ | Primary |
Addresses
Primary practice location
510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Mailing address
510 Hamburg Tpke Ste 108
Wayne, NJ 07470-2033
Phone (973) 925-4111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 61 |
| Removal of skin lesions | 85 |
| Removal of nail tissue | 179 |
| Removal or shaving of skin growth | 46 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MD00380000 | NJ | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Podiatry Center of New Jersey, LLC | Podiatrist | Current | Accepting new patients |
| Parcare Community Health Network Inc | Current | Accepting new patients | |
| Parcare Community Health Network Inc | Current | Accepting new patients |
Locations
510 Hamburg Tpke
Ste 108
Wayne, NJ 07470
Phone (718) 431-4979
4714 16th Ave
Brooklyn, NY 11204
Phone (212) 604-9800
445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320
6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 475-1700
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1730454083
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1942795943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1669053294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 HAMBURG TPKE STE 108",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702033",
"telephone_number": "973-925-4111",
"fax_number": "973-925-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 HAMBURG TPKE STE 108",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702033",
"telephone_number": "973-925-4111",
"fax_number": "973-925-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CYNAMON",
"first_name": "PHILIP",
"middle_name": "J",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00380000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.