NPIMap

Organization Active NPI

Innovative Foot and Ankle, P.a.

  • Foot & Ankle Surgery Podiatrist
  • Montclair, NJ
National Provider Identifier
1861922320
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
INNOVATIVE FOOT AND ANKLE, P.A.
Practice address
119 Grove St
Montclair, NJ 07042-4044
Phone
(973) 783-5101
NPI assigned
Jun 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Sean L. Kaufman, DPMNPI 1821091018
Title
Owner/Provider
Phone
(908) 276-6624

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

119 Grove St
Montclair, NJ 07042-4044

Mailing address

528 Boulevard
Kenilworth, NJ 07033-1657

Other identifiers 1

IdentifierTypeStateIssuer
8719501MedicaidNJ

Other names 1

  • Innovative Foot and Ankle Doing business as

National Provider Directory

National Provider Directory

Locations

834 Avenue C
Bayonne, NJ 07002
Phone (201) 339-4222

274 Main St
Little Ferry, NJ 07643
Phone (201) 440-9444

Practitioners & affiliated clinicians

Practitioners 9

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": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1861922320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 GROVE ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424044",
            "telephone_number": "973-783-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE FOOT AND ANKLE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "908-276-6624",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8719501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovative Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.