Kevin D Holder, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA04662500 Issued in NJ

Practice address

5 Stanley Rd
South Orange, NJ 07079-2721

Phone

(973) 762-6077

Fax

(973) 762-4331

NPI assigned

Mar 8, 2007

Last updated

Mar 28, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Rutgers New Jersey Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Center for Preventative Medicine of New Jersey

  • Internal Medicine Physician
  • South Orange, NJ
  • NPI 1083747299

  Family Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1063543254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 STANLEY RD",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792721",
            "telephone_number": "973-762-6077",
            "fax_number": "973-762-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 STANLEY RD",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792721",
            "telephone_number": "973-762-6077",
            "fax_number": "973-762-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04662500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "020614591",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heartbeat Medical Services LLC
• Thomas E Helbig, MD
• Patrique Henry
• Mal Hill, PHD
• Laura H Hoge, LCSW
• Michael Holder, DPT
• Hope in Motion ABA
• Marion Patricia Houghton, L.M.F.T.
• Kuei-Huang Huang, M.D.
• Caroline Hubschman, LCSW

• Family Medicine Physician in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.