Kevin Shailesh Avichal, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00445700 Issued in NJ

Practice address

2317 Center Island
Route 22
Union, NJ 07083

Phone

(201) 354-1951

Fax

(201) 354-1952

NPI assigned

Aug 26, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.avichal.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347

  NJ

  Medicare reassignment Care Compare group NPD
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540

  NJ

  Medicare reassignment NPD
• Jeffrey F. Augustin, M.D. P.a.

  • Orthopaedic Surgery Physician
  • Bayonne, NJ
  • NPI 1093805384

  NJ

  Medicare reassignment
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555

  Orthopaedic Surgery

  NPD
• Augustin Physical Therapy and Sports Rehab LLC

  • Physical Therapy Clinic/Center
  • Bayonne, NJ
  • NPI 1457073793
  NPD (past)
• DRX Paramus, LLC

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  NPD (past)
• Monmouth Digestive Health LLC

  • Gastroenterology Physician
  • Eatontown, NJ
  • NPI 1831721232
  NPD (past)

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1174040539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 PLANE ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833820",
            "telephone_number": "908-265-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 CENTER ISLAND",
            "address_2": "ROUTE 22",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "201-354-1951",
            "fax_number": "201-354-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVICHAL",
        "first_name": "KEVIN",
        "middle_name": "SHAILESH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-26",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00445700",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MP00445700",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00445700",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Associated Orthopaedics P.a.
• Associates in Family and Geriatric Medicine LLC
• Assure Quality Healthcare Services LLC
• Astra Medical Supply LLC
• Audiology Services Company USA, LLC
• Prity S Avichal
• Avilo Care Services LLC
• Rachel R. Awolowo, NP
• Morgan Axmann, OTD
• Adedolapo Elizabeth Ayediran, DDS

• Medical Physician Assistant in Union, NJ
• Providers in Union, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.