Individual provider Active NPI

Marsha Kallich, MD

  • Infectious Disease Physician
  • East Brunswick, NJ
National Provider Identifier
1053381624
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA40059 Issued in NJ
Practice address
579A Cranbury Rd
Suite 102
East Brunswick, NJ 08816-5426
Phone
(732) 613-0711
Fax
(732) 613-5783
NPI assigned
Jan 25, 2006
Last updated
May 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MA40059 NJ Primary

Addresses

Primary practice location

579A Cranbury Rd
Suite 102
East Brunswick, NJ 08816-5426

Mailing address

579A Cranbury Rd
Suite 102
East Brunswick, NJ 08816-5426
Phone (732) 613-0711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101011000474 NJ Practitioner - Infectious DiseasePractitioner - Internal Medicine 0840482709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

579 A Cranbury Rd
Suite 102
East Brunswick, NJ 08816-5426

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.12
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA40059NJMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Id Care LLC Infectious Disease CurrentSince Nov 1, 2018 Accepting new patients

Locations

579A Cranbury Rd
Ste 102
East Brunswick, NJ 08816
Phone (732) 613-0711

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1053381624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579A CRANBURY RD",
            "address_2": "SUITE 102",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165426",
            "telephone_number": "732-613-0711",
            "fax_number": "732-613-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579A CRANBURY RD",
            "address_2": "SUITE 102",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165426",
            "telephone_number": "732-613-0711",
            "fax_number": "732-613-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLICH",
        "first_name": "MARSHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA40059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.