Muntasir Khaled, DPM LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

MUNTASIR KHALED, DPM LLC

Practice address

309 Memorial Pkwy
Bloomfield, NJ 07003-4264

Phone

(973) 570-8819

Fax

(973) 588-3119

NPI assigned

Apr 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Muntasir Khaled, DPMNPI 1922507003

Title

Owner/Ceo

Phone

(973) 873-0211

Specialties & licenses 1

Addresses

Other names 2

• Foot and Ankle Specialists of North Jersey Doing business as
• Muntasir Khaled, DPM LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Tax ID family

Muntasir Khaled DPM LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Muntasir Khaled, DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Flanders, NJ
  • NPI 1518778232
  NPD tax ID
• Muntasir Khaled, DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Florham Park, NJ
  • NPI 1932917002
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muntasir Khaled, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bloomfield, NJ
  • NPI 1922507003
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1801475223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MEMORIAL PKWY",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034264",
            "telephone_number": "973-873-0211",
            "fax_number": "973-588-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MEMORIAL PKWY",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034264",
            "telephone_number": "973-570-8819",
            "fax_number": "973-588-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Columbia Tpke Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Florham Park",
            "state": "NJ",
            "postal_code": "079322181",
            "country_code": "US",
            "telephone_number": "973-570-8819",
            "fax_number": "973-588-3119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUNTASIR KHALED, DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-04",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "KHALED",
        "authorized_official_first_name": "MUNTASIR",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "973-873-0211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Specialists of North Jersey",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Muntasir Khaled, DPM LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.