Individual provider Active NPI

Kosmas Kasimatis, D.M.D

  • General Practice Dentistry
  • Somerset, NJ
National Provider Identifier
1083830095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI20305 Issued in NJ
Practice address
900 Easton Ave Ste 31
Somerset, NJ 08873-1760
Phone
(732) 247-7417
Fax
(732) 828-7729
NPI assigned
Apr 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI20305 NJ Primary

Addresses

Primary practice location

900 Easton Ave Ste 31
Somerset, NJ 08873-1760

Mailing address

133 Emerson Rd
Somerset, NJ 08873-1616
Phone (908) 510-3080

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611000939 NJ Order and Referring Only - DentistPractitioner - Dentist 7618298936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI20305NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Designs 101 Current Accepting new patients

Locations

900 Easton Ave
Ste 31
Somerset, NJ 08873
Phone (732) 247-7417

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083830095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 EMERSON RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731616",
            "telephone_number": "908-510-3080",
            "fax_number": "732-828-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 EASTON AVE STE 31",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731760",
            "telephone_number": "732-247-7417",
            "fax_number": "732-828-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIMATIS",
        "first_name": "KOSMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI20305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.