At Your Feet Podiatry LLC
Organization Active NPI Podiatrist · Dover, NJ
NPI 1912369166 · NPPES record last updated Mar 27, 2016
Key facts
- NPI
- 1912369166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- License
- 25MD00276200 (NJ)
- Legal business name
- AT YOUR FEET PODIATRY LLC
- Practice address
- 387 W Blackwell St
Dover, NJ 07801-2559 - Phone
- (973) 366-8000
- NPI assigned
- Mar 27, 2016
- Organization subpart
- No
Authorized official
- Name
- Graciani Martinez, D.P.M.
- Title
- Sole Propietor
- Phone
- (917) 445-4992
Practitioners 2
-
Graciani Martinez, D.P.M.
-
Richard Munoz, D.P.M.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160805001896 | NJ | Part B Supplier - Clinic/Group Practice | 5597059006 |
Receives reassigned benefits from 2 practitioners Practice locations: Dover, NJ |
| O20170124001648 | NJ | DME Supplier - Physician - Podiatry | 5597059006 | Practice locations: Dover, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | 25MD00276200 | NJ | Yes |
Addresses
Primary practice location
387 W Blackwell St
Dover, NJ 07801-2559
Mailing address
387 W Blackwell St
Dover, NJ 07801-2559
Other providers in Dover, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.