Active NPI
Fairlawn Podiatry Group PA
- Podiatrist
- Elmwood Park, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- FAIRLAWN PODIATRY GROUP PA
- Practice address
- 1 Broadway Ste 105
Elmwood Park, NJ 07407-1843 - Phone
- (201) 797-3310
- Fax
- (201) 797-1977
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Boris Raginsky, DPM
- Title
- Co Owner
- Phone
- (201) 797-3310
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
1 Broadway Ste 105
Elmwood Park, NJ 07407-1843
Mailing address
1 Broadway Ste 105
Elmwood Park, NJ 07407-1843
Phone (201) 797-3310
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8024901 | Medicaid | NJ | |
| 6702805 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040503001481 | NJ | Part B Supplier - Clinic/Group Practice | 8527056126 |
Receives reassigned benefits from 1 practitioner Practice locations: East Brunswick, NJ; Elmwood Park, NJ; Jersey City, NJ; Old Bridge, NJ |
| O20100930041684 | NJ | DME Supplier - Physician - Podiatry | 8527056126 | Practice locations: Elmwood Park, NJ |
National Provider Directory
National Provider DirectoryLocations
1 Broadway
Ste 401
Elmwood Park, NJ 07407
24-20 Broadway
Ste 4
Fair Lawn, NJ 07410
Phone (201) 797-3310
120 E Halsey Rd
Parsippany, NJ 07054
Phone (201) 667-6971
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- East Brunswick, NJ
- NPI 1457352502
Foot & Ankle Surgery, NJ
-
- Endocrinology, Diabetes & Metabolism Physician
- East Brunswick, NJ
- NPI 1609961408
-
- Allergy & Immunology Physician
- Highland Park, NJ
- NPI 1366427585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767744000000",
"number": "1710043740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BROADWAY STE 105",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071843",
"telephone_number": "201-797-3310",
"fax_number": "201-797-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BROADWAY STE 105",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071843",
"telephone_number": "201-797-3310",
"fax_number": "201-797-1977"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRLAWN PODIATRY GROUP PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-27",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A",
"authorized_official_last_name": "RAGINSKY",
"authorized_official_first_name": "BORIS",
"authorized_official_title_or_position": "CO OWNER",
"authorized_official_telephone_number": "201-797-3310",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8024901",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6702805",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elmwood Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.