Active NPI
Samet Kucukcolak
- Anatomic Pathology & Clinical Pathology Physician
- New Brunswick, NJ
National Provider Identifier
1083294425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 25MA12628100
- Practice address
- 330 Livingston Ave Ste 221
New Brunswick, NJ 08901-3469 - Phone
- (732) 543-0600
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 25MA12628100 | NJ | Primary |
Addresses
Primary practice location
330 Livingston Ave Ste 221
New Brunswick, NJ 08901-3469
Mailing address
524 Bluff Rd
Fort Lee, NJ 07024-1543
Phone (201) 616-9188
Other practice location 1
524 Bluff Rd
Fort Lee, NJ 07024-1543
Phone (201) 616-9188
Other practice location 2
1 Robert Wood Johnson Pl
New Brunswick, NJ 08901-1928
Phone (732) 235-8118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12628100 | NJ | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749772800000",
"number": "1083294425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 BLUFF RD",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070241543",
"telephone_number": "201-616-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 LIVINGSTON AVE STE 221",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089013469",
"telephone_number": "732-543-0600"
}
],
"practiceLocations": [
{
"address_1": "524 Bluff Rd",
"address_purpose": "LOCATION",
"city": "Fort Lee",
"state": "NJ",
"postal_code": "070241543",
"country_code": "US",
"telephone_number": "201-616-9188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Robert Wood Johnson Pl",
"address_purpose": "LOCATION",
"city": "New Brunswick",
"state": "NJ",
"postal_code": "089011928",
"country_code": "US",
"telephone_number": "732-235-8118",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUCUKCOLAK",
"first_name": "SAMET",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2025-06-13",
"certification_date": "2025-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NJ",
"license": "25MA12628100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.