NPIMap

Organization Active NPI

Brucato Foot and Ankle Surgery

  • Foot & Ankle Surgery Podiatrist
  • Clifton, NJ
National Provider Identifier
1871050948
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BRUCATO FOOT AND ANKLE SURGERY
Practice address
1011 Clifton Ave
Clifton, NJ 07013-3518
Phone
(732) 691-0279
NPI assigned
Feb 26, 2019
Last updated
Nov 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Authorized official

Name
Dr. Maryellen Patricia Brucato, DPMNPI 1407148877
Title
Owner
Phone
(732) 691-0279

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 Podiatrist 213ES0103X Primary

Addresses

Primary practice location

1011 Clifton Ave
Clifton, NJ 07013-3518

Mailing address

1011 Clifton Ave
Clifton, NJ 07013-3518
Phone (732) 691-0279

Other names 1

  • New Jersey Foot & Ankle Centers 2 LLC Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190523001396 NJ Part B Supplier - Clinic/Group Practice 2769725282 Receives reassigned benefits from 7 practitioners
Practice locations: Clifton, NJ; Hackensack, NJ; Parsippany, NJ
O20190726000433 NJ DME Supplier - Physician - General Practice 2769725282 Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

140 Prospect Ave
Ste 16
Hackensack, NJ 07601
Phone (201) 880-0505

181 New Rd
Ste 201
Parsippany, NJ 07054
Phone (201) 366-6256

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1871050948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133518",
            "telephone_number": "732-691-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133518",
            "telephone_number": "732-691-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCATO FOOT AND ANKLE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "BRUCATO",
        "authorized_official_first_name": "MARYELLEN",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-691-0279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Jersey Foot & Ankle Centers 2 LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.