Individual provider Active NPI

Venus T Khalil, M.D.

  • Family Medicine Physician
  • East Brunswick, NJ
National Provider Identifier
1073559860
Registry record updated Jan 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA06517700 Issued in NJ
Practice address
3 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone
(732) 432-9923
Fax
(732) 432-0030
NPI assigned
Jun 21, 2006
Last updated
Jan 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA06517700 NJ Primary

Addresses

Primary practice location

3 Brunswick Woods Dr
East Brunswick, NJ 08816-5601

Mailing address

3 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone (732) 432-9923

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
I20050613001111 NJ Practitioner - Family Practice 9133163934 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA06517700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of North Jersey P C CurrentSince Oct 1, 2014 Accepting new patients

Locations

1 Hospital Plz
Old Bridge, NJ 08857
Phone (732) 324-4158

530 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 324-5007

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Organizations & group practices 2

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357430400000",
    "number": "1073559860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BRUNSWICK WOODS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165601",
            "telephone_number": "732-432-9923",
            "fax_number": "732-432-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRUNSWICK WOODS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165601",
            "telephone_number": "732-432-9923",
            "fax_number": "732-432-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "VENUS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA06517700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.