Individual provider Active NPI

Brandon A Macy, DPM

  • Primary Podiatric Medicine Podiatrist
  • Clark, NJ
National Provider Identifier
1720083538
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
25MD00126200 Issued in NJ
Practice address
1114 Raritan Rd
Clark, NJ 07066-1330
Phone
(732) 382-3470
Fax
(732) 301-8262
NPI assigned
Jun 17, 2005
Last updated
Sep 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 25MD00126200 NJ Primary

Addresses

Primary practice location

1114 Raritan Rd
Clark, NJ 07066-1330

Mailing address

1114 Raritan Rd
Clark, NJ 07066-1330
Phone (732) 382-3470

Other identifiers 1

IdentifierTypeStateIssuer
3057101MedicaidNJ

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
I20071012000077 NJ Practitioner - Podiatry 5799871398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4633 Hwy 9
Howell, NJ 07731-3324

4633 US Hwy 9
Howell, NJ 07731-3324

4645 Hwy 9
Howell, NJ 07731-3324
Phone (732) 905-1110

7 Chase Rd
Lumberton, NJ 08048-6203
Phone (856) 764-4400

85 S Jefferson St
Suite 2 Morris Podiatry Associates PA
Orange, NJ 07050-1562
Phone (973) 678-5000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue790
Removal or shaving of skin growth220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00126200NJMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Podiatric Physicians & Surgeons Group, LLC Primary Podiatric Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brandonm@cpc-nj.direct.office.nextgen.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1720083538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661330",
            "telephone_number": "732-382-3470",
            "fax_number": "732-301-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661330",
            "telephone_number": "732-382-3470",
            "fax_number": "732-301-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACY",
        "first_name": "BRANDON",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "25MD00126200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3057101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

Verify at the official NPI Registry.