Individual provider Active NPI

Michelle Suh, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ridgewood, NJ
National Provider Identifier
1780099044
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00337400 Issued in NJ
Practice address
400 Rte 17
Ridgewood, NJ 07450-2010
Phone
(201) 445-2288
Fax
(201) 445-2288
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 25MD00337400 NJ Primary

Addresses

Primary practice location

400 Rte 17
Ridgewood, NJ 07450-2010

Mailing address

400 Rte 17
Ridgewood, NJ 07450-2010
Phone (201) 445-2288

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
I20170815003931 NJ Practitioner - Podiatry 6608148317 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00337400NJMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Foot and Ankle Foot & Ankle Surgery CurrentSince Jul 2, 2022 Accepting new patients
Fellowship Village Inc. CurrentSince Feb 1, 2023 Accepting new patients
Fellowship Senior Living, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Proactive Foot and Ankle CurrentSince Jul 2, 2022 Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

74 Pascack Rd
Ste 6
Park Ridge, NJ 07656
Phone (201) 291-1113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780099044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RTE 17",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502010",
            "telephone_number": "201-445-2288",
            "fax_number": "201-445-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RTE 17",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502010",
            "telephone_number": "201-445-2288",
            "fax_number": "201-445-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "MICHELLE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00337400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.