Kirby Douglas Rekedal, M.D.
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Long Branch, NJ
NPI 1023197969 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023197969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- 25MA04623700 (NJ)
- Practice address
- 300 2ND Ave
Long Branch, NJ 07740-6303 - Phone
- (732) 923-6860
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- University of Maryland School of Medicine, 1980
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4991 Lake Brook Dr
Suite 300
Glen Allen, VA 23060-9245
66 W Gilbert St
Tinton Falls, NJ 07701-4948
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260420003190 | NJ | Practitioner - Pediatric Medicine | 2466639505 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monmouth Medical Center Inc | Past | Accepting new patients | |
| Monmouth Medical Center Faculty Practice Plan, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 25MA04623700 | NJ | Yes |
Addresses
Primary practice location
300 2ND Ave
Long Branch, NJ 07740-6303
Mailing address
255 3Rd Ave
Long Branch, NJ 07740-6214
Other providers in Long Branch, NJ
- Regina M. Doyle, LCSW, LLC
- Ben Regis
- Korie Rego
- Eric Rehr
- Raissa Santos Reimann
- Richard A Reutter
- Brian Revfi
- Ryan Richards
- Tyler Mark Richards
- Ahron Richter
All providers in Long Branch, NJ · Neonatal-Perinatal Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.