Individual provider Active NPI

Sunaina Kanchan, PA

  • Physician Assistant
  • Carteret, NJ
National Provider Identifier
1154188902
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00840700 Issued in NJ
Practice address
125 Washington Ave
Carteret, NJ 07008-2635
Phone
(732) 541-6521
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 25MP00840700 NJ Primary

Addresses

Primary practice location

125 Washington Ave
Carteret, NJ 07008-2635

Mailing address

125 Washington Ave
Carteret, NJ 07008-2635
Phone (732) 541-6521

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314001604 NJ Practitioner - Physician Assistant 8820434632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carteret Medical Enterprise IncGroup PAC ID 9234026444, 5 clinicians

Practice addresses (Care Compare)

125 Washington Ave
Carteret, NJ 07008-2946
Phone (732) 541-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00840700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson MD Group Past Accepting new patients
BSD NJ Medical LLC PastSince Mar 14, 2015 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1154188902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WASHINGTON AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082635",
            "telephone_number": "732-541-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WASHINGTON AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082635",
            "telephone_number": "732-541-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANCHAN",
        "first_name": "SUNAINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00840700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carteret, NJ

Sources for this page

Verify at the official NPI Registry.