Individual provider Active NPI

Rachna Kaul, MD

  • Family Medicine Physician
  • Ridgewood, NJ
National Provider Identifier
1073776340
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09476400 Issued in NJ
Practice address
61 N Maple Ave Ste 204B
Ridgewood, NJ 07450-3232
Phone
(201) 639-4250
Fax
(201) 639-4250
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A262951 NY
Family Medicine Physician 207Q00000X 25MA09476400 NJ Primary

Addresses

Primary practice location

61 N Maple Ave Ste 204B
Ridgewood, NJ 07450-3232

Mailing address

61 N Maple Ave Ste 204B
Ridgewood, NJ 07450-3232
Phone (201) 639-4250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 8, 2019 through Apr 8, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A262951NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Radiology Group of New Jersey, LLC Past Accepting new patients

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1073776340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 N MAPLE AVE STE 204B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503232",
            "telephone_number": "201-639-4250",
            "fax_number": "201-639-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 N MAPLE AVE STE 204B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503232",
            "telephone_number": "201-639-4250",
            "fax_number": "201-639-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUL",
        "first_name": "RACHNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "A262951",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09476400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.