CMS-1500 Box 24J / 33a • NPI
1093217622
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
213ES0103X (CMS 48)
Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery
Box 32 Service Location & ZIP+4
2035 HAMBURG TPKE STE B, WAYNE, NJ, 07470-6251
✓ 9-Digit EDI 837 ZIP+4 (07470-6251)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093217622 (ACTIVE PODIATRY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093217622 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ACTIVE PODIATRY LLC |
| Plain-English Specialty | Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery NUCC Code: 213ES0103X (Podiatrist, Foot & Ankle Surgery) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2035 HAMBURG TPKE STE B, WAYNE, NJ, 07470-6251 |
| Practice Telephone / Fax | Tel: (201) 614-3668 | Fax: (973) 256-4757 |
| Administrative Mailing Address | 2035 HAMBURG TPKE STE B, WAYNE, NJ, 07470-6251 |
| Enumeration & Last Sync | Enumerated: 2018-02-28 | CMS Record Updated: 2025-09-02 |
| Authorized Official | HOMAM BADRI (DPM) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (213ES0103X)
What Does Taxonomy Code 213ES0103X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213ES0103X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ACTIVE PODIATRY LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
213ES0103X — Podiatrist, Foot & Ankle SurgeryPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery | State: NJ | License: 25MD0032100 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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