INNOVATIVE FOOT AND ANKLE P.A. NPI 1861922320

NPI Information

NPI: 1861922320
Provider Name: INNOVATIVE FOOT AND ANKLE, P.A.
Classification: Podiatrist - 213ES0103X
Specialization: Foot & Ankle Surgery
Entity Type: Organization
Doing Business As: INNOVATIVE FOOT AND ANKLE
Address: 119 GROVE ST
MONTCLAIR, NJ
ZIP 07042
Phone: (973) 783-5101

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NPI Details

INNOVATIVE FOOT AND ANKLE, P.A. is a foot and ankle surgery podiatrist in Montclair, NJ. INNOVATIVE FOOT AND ANKLE, P.A. NPI is 1861922320. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Innovative Foot And Ankle.

The provider's business location address is:

119 GROVE ST
MONTCLAIR, NJ
ZIP 07042-044
Phone: (973) 783-5101

The provider's authorized official is Sean L. Kaufman .
The authorized official title is Owner/provider and has the following contact phone number (908) 276-6624.

The enumeration date for this NPI number is 6/18/2017 and was last updated on 9/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8719501	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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