MEDICARE: BOLTROPE PODIATRY NY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	213ES0131X	Foot Surgery Podiatrist
2	213ES0103X	Foot & Ankle Surgery Podiatrist
3	207ZP0101X	Anatomic Pathology Physician
4	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1912641150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOLTROPE PODIATRY NY PLLC

Provider Business Mailing Address
First Line	:	365 W PASSAIC ST STE 530
Second Line	:
City	:	ROCHELLE PARK
State	:	NJ
Zip	:	07662-3012
Country	:	US
Telephone Number	:	201-571-0214
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 MAIN ST
Second Line	:
City	:	NANUET
State	:	NY
Zip	:	10954-2884
Country	:	US
Telephone Number	:	845-623-5863
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JEFFREY GEWIRTZ
Credential	:
Telephone Number	:	201-391-1113

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	11/13/2025

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