Individual provider Active NPI

Ritesh Kalra, M.D.

  • Internal Medicine Physician
  • Fair Lawn, NJ
National Provider Identifier
1043436348
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08381300 Issued in NJ
Practice address
15-01 Broadway Ste 8
Fair Lawn, NJ 07410-6018
Phone
(201) 796-8060
Fax
(201) 796-8070
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243355 NY
Internal Medicine Physician 207R00000X 25MA08381300 NJ Primary

Addresses

Primary practice location

15-01 Broadway Ste 8
Fair Lawn, NJ 07410-6018

Mailing address

38 Creekside CT
Secaucus, NJ 07094-3750
Phone (201) 210-2186

Other practice location 1

15-01 Broadway Ste 8
Fair Lawn, NJ 07410-6018
Phone (201) 796-8060

Other identifiers 2

IdentifierTypeStateIssuer
0238813MedicaidNJ
1043436348OtherNYHORIZEN BLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081107000059 NJ Practitioner - Internal Medicine 9638263890 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08381300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Incare LLC Internal Medicine Past Accepting new patients
University Hospital Past Accepting new patients
Mid-County Pulmonary Associate P C Past Accepting new patients
Becker Medical, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCAGBD/Endpoint/DCAGBD
  • Direct secure messaging: ritesh.kalra@direct.hobokenumc.md

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043436348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CREEKSIDE CT",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943750",
            "telephone_number": "201-210-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY STE 8",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106018",
            "telephone_number": "201-796-8060",
            "fax_number": "201-796-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15-01 Broadway Ste 8",
            "address_purpose": "LOCATION",
            "city": "Fair Lawn",
            "state": "NJ",
            "postal_code": "074106018",
            "country_code": "US",
            "telephone_number": "201-796-8060",
            "fax_number": "201-796-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALRA",
        "first_name": "RITESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "243355",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08381300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0238813",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZEN BLUE CROSS BLUE SHEILD",
            "identifier": "1043436348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.