Individual provider Active NPI

Michael Rosenblum, DPM

  • Podiatrist
  • Fair Lawn, NJ
National Provider Identifier
1700834652
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD002464 Issued in NJ
Practice address
14-25 Plaza Rd
Fair Lawn, NJ 07410-3546
Phone
(201) 773-8686
Fax
(201) 773-8683
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD002464 NJ Primary

Addresses

Primary practice location

14-25 Plaza Rd
Fair Lawn, NJ 07410-3546

Mailing address

18-05 Hillery St
Fair Lawn, NJ 07410-5208
Phone (201) 773-8686

Other identifiers 1

IdentifierTypeStateIssuer
7928301MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050202000815 NJ Practitioner - Podiatry 5799736179 Practice locations: Fair Lawn, NJ; Montclair, NJ; Paterson, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 -05 Hillery St
Fair Lawn, NJ 07410-5208
Phone (201) 773-0428

Merit-based Incentive Payment System (MIPS)

Final score
85.89 of 100Reported as individual
Quality
68.34
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue54
Removal of skin lesions28
Removal of nail tissue1355
Removal or shaving of skin growth1296
Skin biopsy15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD002464NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Rosenblum, DPM Podiatrist CurrentSince May 1, 2006 Accepting new patients
Med Solutions, LLC Past Accepting new patients
North Hudson Community Action Corporation Past Accepting new patients
G&S Medical Associates LLC Podiatrist Past Accepting new patients

Locations

14-25 Plaza Rd
Ste N3
Fair Lawn, NJ 07410

14-25 Plaza Rd
Fair Lawn, NJ 07410
Phone (201) 797-7373

14-25 Plaza Rd
Ste 524
Fair Lawn, NJ 07410

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1700834652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18-05 HILLERY ST",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105208",
            "telephone_number": "201-773-8686",
            "fax_number": "201-773-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-25 PLAZA RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103546",
            "telephone_number": "201-773-8686",
            "fax_number": "201-773-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLUM",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD002464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7928301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.