Organization Active NPI

Robert E. Sussman, D.P.M.,P.C.

  • Podiatrist
  • Neptune, NJ
National Provider Identifier
1851414072
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD01549000 Issued in NJ
Legal business name
ROBERT E. SUSSMAN, D.P.M.,P.C.
Practice address
2100 State Route 33 Ste 3
Neptune, NJ 07753-6116
Phone
(732) 776-7260
Fax
(732) 774-8370
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Robert E Sussman, D.P.M.NPI 1013944917
Title
Proprietor
Phone
(732) 776-7260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 25MD01549000 NJ Primary

Addresses

Primary practice location

2100 State Route 33 Ste 3
Neptune, NJ 07753-6116

Mailing address

2100 State Route 33 Ste 3
Neptune, NJ 07753-6116
Phone (732) 776-7260

Other identifiers 1

IdentifierTypeStateIssuer
3382401MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080603000584 NJ Part B Supplier - Clinic/Group Practice 5496825424 Receives reassigned benefits from 2 practitioners
Practice locations: Neptune, NJ
O20100930092661 NJ DME Supplier - Physician - Podiatry 5496825424 Practice locations: Neptune City, NJ

National Provider Directory

National Provider Directory

Locations

1820 State Route 33
Ste 9
Neptune, NJ 07753
Phone (732) 776-7260

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1851414072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STATE ROUTE 33 STE 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077536116",
            "telephone_number": "732-776-7260",
            "fax_number": "732-774-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STATE ROUTE 33 STE 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077536116",
            "telephone_number": "732-776-7260",
            "fax_number": "732-774-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E. SUSSMAN, D.P.M.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "732-776-7260",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD01549000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3382401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.