Individual provider Active NPI

Marni Ilana Kaplan Broder, DPM

  • Foot & Ankle Surgery Podiatrist
  • Edison, NJ
National Provider Identifier
1750519757
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00297900 Issued in NJ
Practice address
27 Celler Rd
Edison, NJ 08817-2971
Phone
(201) 674-8000
NPI assigned
Jun 29, 2009
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 25MD00297900 NJ Primary

Addresses

Primary practice location

27 Celler Rd
Edison, NJ 08817-2971

Mailing address

27 Celler Rd
Edison, NJ 08817-2971
Phone (201) 674-8000

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
I20100506000936 NJ Practitioner - Podiatry 8426186735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 Veronica Ave
Suite 203
Somerset, NJ 08873-5002
Phone (732) 978-2700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue16
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00297900NJMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Health Partners PastSince Apr 30, 2023 Accepting new patients
Park Avenue Family Foot Care P.C. Foot & Ankle Surgery PastSince Jun 1, 2017 Accepting new patients
Central Jersey Surgical Specialists, P.a. PastSince Jan 5, 2020 Accepting new patients

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, 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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1750519757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CELLER RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172971",
            "telephone_number": "201-674-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CELLER RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172971",
            "telephone_number": "201-674-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN BRODER",
        "first_name": "MARNI",
        "middle_name": "ILANA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00297900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.