Kaitlin Dickert Gonzales, D.P.M

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00327900 Issued in NJ

Practice address

121 Center Grove Rd
Randolph, NJ 07869-4453

Phone

(973) 366-1016

Fax

(973) 366-5925

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlin Elyse Dickert Former name

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamic Foot and AnkleGroup PAC ID 0547684011, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dynamic Foot & Ankle

  • Podiatrist
  • Randolph, NJ
  • NPI 1730700907
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1821431909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CENTER GROVE RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694453",
            "telephone_number": "973-366-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CENTER GROVE RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694453",
            "telephone_number": "973-366-1016",
            "fax_number": "973-366-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Northfield Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070394896",
            "country_code": "US",
            "telephone_number": "973-716-0666 x609",
            "fax_number": "973-366-5925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "528 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Kenilworth",
            "state": "NJ",
            "postal_code": "070331657",
            "country_code": "US",
            "telephone_number": "908-276-6624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "776 E 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Roselle",
            "state": "NJ",
            "postal_code": "072031698",
            "country_code": "US",
            "telephone_number": "908-280-4314 x90828",
            "fax_number": "973-366-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "KAITLIN",
        "middle_name": "DICKERT",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00327900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "DICKERT",
            "middle_name": "ELYSE",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meghan Mary Giusti
• Robert Gold, DMD
• Elisabeth Rachel Goldstein, M.D.
• Glen M Goldstein
• Zachary Goldstein, DMD
• Ricki L Gottlieb, M.D.
• Thomas J Grable, ATC, PTA
• Sara Grapski, NCSP
• Deanna Graziani, DPT
• Great Atlantic & Pacific Tea Company Inc

• Podiatrist in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.