Individual provider Active NPI

Justin Paul Kaminski, DPM

  • Foot & Ankle Surgery Podiatrist
  • Peabody, MA
National Provider Identifier
1790199412
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2456 Issued in MA
Practice address
6 Essex Center Dr Ste 208
Peabody, MA 01960-2906
Phone
(978) 531-9969
NPI assigned
Jun 20, 2014
Sex
Male
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 2456 MA Primary

Addresses

Primary practice location

6 Essex Center Dr Ste 208
Peabody, MA 01960-2906

Mailing address

6 Essex Center Dr Ste 208
Peabody, MA 01960-2906
Phone (978) 531-9969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170914001038 MA Practitioner - Podiatry 1759655756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peabody Podiatry LLCGroup PAC ID 9335232735, 5 clinicians

Practice addresses (Care Compare)

6 Essex Ctr Dr
Suite 208
Peabody, MA 01960-2906
Phone (978) 531-9969

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue531
Removal of skin lesions21
Removal of nail tissue1350
Removal or shaving of skin growth440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2456MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peabody Podiatry LLC CurrentSince Jul 24, 2017 Accepting new patients

Locations

6 Essex Center Dr
Ste 208
Peabody, MA 01960
Phone (978) 531-9969

Interoperability endpoints

  • Direct secure messaging: kaminski.justin.ppdpm@direct.partners.masshiway.net

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790199412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR STE 208",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602906",
            "telephone_number": "978-531-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR STE 208",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602906",
            "telephone_number": "978-531-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "JUSTIN",
        "middle_name": "PAUL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "2456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.