Active NPI
Mona Khedkar, M.D.
- Diagnostic Radiology Physician
- Nutley, NJ
National Provider Identifier
1013023423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25MA03586700
- Practice address
- 410 Centre St
Nutley, NJ 07110-1635 - Phone
- (973) 661-0006
- Fax
- (973) 661-4473
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 25MA03586700 | NJ | Primary |
Addresses
Primary practice location
410 Centre St
Nutley, NJ 07110-1635
Mailing address
410 Centre St
Nutley, NJ 07110-1635
Phone (973) 661-0006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03586700 | NJ | MD | Diagnostic Radiology Physician |
Interoperability endpoints
- https://api.platform.athenahealth.com/19801/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1013023423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 CENTRE ST",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071101635",
"telephone_number": "973-661-0006",
"fax_number": "973-661-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 CENTRE ST",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071101635",
"telephone_number": "973-661-0006",
"fax_number": "973-661-4473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHEDKAR",
"first_name": "MONA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NJ",
"license": "25MA03586700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.