Ibrahim Kak, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MA11798300 Issued in NJ

Practice address

65 James St
Edison, NJ 08820-3947

Phone

(732) 321-7000

NPI assigned

Apr 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMHMG Specialty Care

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Pediatrics

  Medicare reassignment NPD
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMMG New Jersey Oral & Maxillofacial Surgery

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  NPD (past)

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1093343188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577679",
            "country_code": "US",
            "telephone_number": "718-992-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAK",
        "first_name": "IBRAHIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA11798300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "327924",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA11798300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Justice
• Hilda Justin Jose
• Andrei Kachala, MD
• Jacob Kader, PSY.D.
• Miles Allin Kahrl
• James Nicholas Kalonturos, D.C.
• Amira Kamara
• Yealisha A Kamara, DPT
• Joy Simcha Kameo
• Shameem Kamra

• General Practice Physician in Edison, NJ
• Providers in Edison, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.