Individual provider Active NPI

Brian Matthew Levine, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jersey City, NJ
National Provider Identifier
1770787608
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00291500 Issued in NJ
Practice address
550 Summit Ave
Basement Office
Jersey City, NJ 07306-2707
Phone
(201) 303-1875
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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 25MD00291500 NJ Primary

Addresses

Primary practice location

550 Summit Ave
Basement Office
Jersey City, NJ 07306-2707

Mailing address

14 Post LN
Livingston, NJ 07039-4905
Phone (973) 953-3275

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
I20100929000219 NJ Practitioner - Podiatry 9234255159 Practice locations: East Orange, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Foot and Ankle Care Foot & Ankle Surgery Current Accepting new patients

Locations

550 Summit Ave
Bsmt
Jersey City, NJ 07306
Phone (201) 209-1802

Organizations & group practices 1

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1770787608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 POST LN",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394905",
            "telephone_number": "973-953-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SUMMIT AVE",
            "address_2": "BASEMENT OFFICE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062707",
            "telephone_number": "201-303-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00291500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.