Active NPI
Michael Rosenblum, DPM
- Podiatrist
- Fair Lawn, NJ
National Provider Identifier
1700834652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- MD002464
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7928301 | Medicaid | NJ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 100
- Quality
- 68.34
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 54 |
| Removal of skin lesions | 28 |
| Removal of nail tissue | 1355 |
| Removal or shaving of skin growth | 1296 |
| Skin biopsy | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD002464 | NJ | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Rosenblum, DPM | Podiatrist | Current | 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.
-
- Podiatrist
- Fair Lawn, NJ
- NPI 1396928958
-
- Pulmonary Disease Physician
- West Paterson, NJ
- NPI 1972652634
-
- Federally Qualified Health Center (FQHC)
- Secaucus, NJ
- NPI 1043465057
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.