Individual provider Active NPI

Warren A Pasternack, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • East Brunswick, NJ
National Provider Identifier
1699774620
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00116600 Issued in NJ
Practice address
B2 Brier Hill CT
East Brunswick, NJ 08816-3348
Phone
(732) 254-9302
Fax
(732) 613-4758
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00116600 NJ Primary

Addresses

Primary practice location

B2 Brier Hill CT
East Brunswick, NJ 08816-3348

Mailing address

3 Jason Dr
E Brunswick, NJ 08816-3342
Phone (732) 254-1007

Other identifiers 1

IdentifierTypeStateIssuer
0650404MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00116600NJMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1699774620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 JASON DR",
            "city": "E BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163342",
            "telephone_number": "732-254-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B2 BRIER HILL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163348",
            "telephone_number": "732-254-9302",
            "fax_number": "732-613-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTERNACK",
        "first_name": "WARREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00116600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0650404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.