NPIMap

Organization Active NPI

Kuflik Dermatology, P. a.

  • Dermatology Physician
  • Toms River, NJ
National Provider Identifier
1174637722
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
KUFLIK DERMATOLOGY, P. A.
Practice address
453 Lakehurst Rd
Toms River, NJ 08755-6342
Phone
(732) 341-0515
Fax
(732) 240-0933
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Authorized official

Name
Dr. Avery Kuflik, M.D.NPI 1952415705
Title
President
Phone
(732) 341-0515

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

453 Lakehurst Rd
Toms River, NJ 08755-6342

Mailing address

453 Lakehurst Rd
Toms River, NJ 08755-6342
Phone (732) 341-0515

Other names 1

  • Emanuel G. Kuflik, MD, P. A. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000897 NJ Part B Supplier - Clinic/Group Practice 6901891654 Receives reassigned benefits from 9 practitioners
Practice locations: Sea Girt, NJ; Whiting, NJ; Toms River, NJ; Manahawkin, NJ; Jackson, NJ

National Provider Directory

National Provider Directory

Locations

27 S Cooks Bridge Rd
Ste 1-12
Jackson, NJ 08527
Phone (732) 341-0515

150 E Kennedy Blvd
Lakewood, NJ 08701
Phone (732) 364-0515

2130 Highway 35
Ste A113
Sea Girt, NJ 08750

453 Lakehurst Rd
Toms River, NJ 08755
Phone (732) 341-0515

Practitioners & affiliated clinicians

Practitioners 11

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": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1174637722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 LAKEHURST RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556342",
            "telephone_number": "732-341-0515",
            "fax_number": "732-240-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 LAKEHURST RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556342",
            "telephone_number": "732-341-0515",
            "fax_number": "732-240-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUFLIK DERMATOLOGY, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "KUFLIK",
        "authorized_official_first_name": "AVERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-341-0515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emanuel G. Kuflik, MD, P. A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.