NPIMap

Organization Active NPI

Integrated Foot and Ankle Specialists of NJ LLC

  • Foot & Ankle Surgery Podiatrist
  • Marlton, NJ
National Provider Identifier
1679284285
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
INTEGRATED FOOT AND ANKLE SPECIALISTS OF NJ LLC
Practice address
523 Route 73N
Suite 117a
Marlton, NJ 08053
Phone
(484) 535-3285
Fax
(484) 535-5446
NPI assigned
Dec 6, 2022
Last updated
Dec 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Teresa Leonarda Ciaccio
Title
President & Chief Operating Officer
Phone
(516) 993-8666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

523 Route 73N
Suite 117a
Marlton, NJ 08053

Mailing address

523 Route 73N
Suite 117a
Marlton, NJ 08053
Phone (484) 535-3285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230826000005 NJ Part B Supplier - Clinic/Group Practice 0547623332 Receives reassigned benefits from 16 practitioners
Practice locations: Mullica Hill, NJ; Voorhees, NJ; Turnersville, NJ; Somers Point, NJ; Sewell, NJ; Moorestown, NJ; Linwood, NJ; Cherry Hill, NJ…

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Integrated Foot and Ankle Specialists of NJ LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

69 Haddonfield Berlin Rd
Ste 1
Cherry Hill, NJ 08034
Phone (856) 429-5838

523 Rte 73N
Ste 117a
Marlton, NJ 08053
Phone (484) 535-3285

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1679284285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 ROUTE 73N",
            "address_2": "SUITE 117A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "484-535-3285",
            "fax_number": "484-535-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 ROUTE 73N",
            "address_2": "SUITE 117A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "484-535-3285",
            "fax_number": "484-535-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "CIACCIO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LEONARDA",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "516-993-8666"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.