Organization Active NPI

Roger Keshav MD PA

  • Nephrology Physician
  • Belleville, NJ
National Provider Identifier
1104294909
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA09265200 Issued in NJ
Legal business name
ROGER KESHAV MD PA
Practice address
140 Belmont Ave
Suite 102
Belleville, NJ 07109-1018
Phone
(973) 751-7870
Fax
(973) 751-7875
NPI assigned
Sep 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Roger Keshav, MDNPI 1942525316
Title
Owner
Phone
(973) 751-7870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 25MA09265200 NJ Primary

Addresses

Primary practice location

140 Belmont Ave
Suite 102
Belleville, NJ 07109-1018

Mailing address

140 Belmont Ave
Suite 102
Belleville, NJ 07109-1018
Phone (973) 751-7870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151012001053 NJ Part B Supplier - Clinic/Group Practice 1658680772 Receives reassigned benefits from 1 practitioner
Practice locations: Belleville, NJ

National Provider Directory

National Provider Directory

Locations

140 Belmont Ave
Belleville, NJ 07109
Phone (973) 751-7870

140 Belmont Ave
Ste 102
Belleville, NJ 07109
Phone (973) 751-7870

268 M L King Blvd
Newark, NJ 07102
Phone (201) 861-0026

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1104294909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BELMONT AVE",
            "address_2": "SUITE 102",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091018",
            "telephone_number": "973-751-7870",
            "fax_number": "973-751-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BELMONT AVE",
            "address_2": "SUITE 102",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091018",
            "telephone_number": "973-751-7870",
            "fax_number": "973-751-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER KESHAV MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "KESHAV",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-751-7870",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA09265200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.