Individual provider Active NPI

Benjamin Kashan, M.D.

  • Surgery Physician
  • Passaic, NJ
National Provider Identifier
1063767903
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA10961000 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 877-5080
NPI assigned
Jul 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA10961000 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

PO Box 51020
Newark, NJ 07101-5120
Phone (570) 366-4606

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201231000059 NJ Practitioner - General Surgery 2365721149 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys General Medical Group PCGroup PAC ID 5496112476, 73 clinicians

Practice addresses (Care Compare)

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

905 Allwood Rd
Suite 204
Clifton, NJ 07012-1946
Phone (973) 778-6676

Hospital & facility affiliations

  • St Mary'S General Hospital Hospital, Passaic, NJ, CCN 310006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10961000NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMGH Physician Practice Management, LLC CurrentSince Dec 1, 2020 Accepting new patients
Central Avenue Professional Services, PC Surgery CurrentSince Jan 8, 2021 Accepting new patients
St Marys General Medical Group PC Surgery CurrentSince Jul 1, 2023 Accepting new patients
General and Vascular Surgical Associates of North Jersey, P.a. Surgery Past Accepting new patients

Locations

905 Allwood Rd
Ste 204
Clifton, NJ 07012
Phone (201) 407-6456

1100 Clifton Ave
Ste 1B
Clifton, NJ 07013
Phone (973) 321-1670

1033 Clifton Ave
Clifton, NJ 07013
Phone (973) 473-5700

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

268 Dr Martin Luther King Jr Blvd
Newark, NJ 07102
Phone (973) 678-5700

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

Interoperability endpoints

  • Direct secure messaging: benjamin.kashan@generalvascularsurgassocofnj.chartmakerdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1063767903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51020",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071015120",
            "telephone_number": "570-366-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-877-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHAN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA10961000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.