Individual provider Active NPI

John Zatourian

  • Podiatrist
  • Newark, NJ
National Provider Identifier
1902937568
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD00170000 Issued in NJ
Practice address
389 Sanford Ave
Newark, NJ 07106-1149
Phone
(973) 371-5978
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD00170000 NJ Primary

Addresses

Primary practice location

389 Sanford Ave
Newark, NJ 07106-1149

Mailing address

560 Vail Rd
Parsippany, NJ 07054-1435
Phone (973) 334-3734

Other identifiers 1

IdentifierTypeStateIssuer
0711506MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120201000161 NJ Practitioner - Podiatry 1557528643 Practice locations: Newark, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

389 Sanford Ave
Newark, NJ 07106-1149
Phone (973) 371-5978

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD00170000NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Avenue Professional Services, PC Podiatrist Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1902937568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VAIL RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541435",
            "telephone_number": "973-334-3734",
            "fax_number": "973-334-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 SANFORD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071061149",
            "telephone_number": "973-371-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZATOURIAN",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD00170000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0711506",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.