Individual provider Active NPI

Malasa Jois Kahn, DO

  • Family Medicine Physician
  • Montclair, NJ
National Provider Identifier
1184037079
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10218700 Issued in NJ
Practice address
100 Valley Rd Ste 102
Montclair, NJ 07042-2200
Phone
(973) 965-8409
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB10218700 NJ Primary

Addresses

Primary practice location

100 Valley Rd Ste 102
Montclair, NJ 07042-2200

Mailing address

100 Valley Rd Ste 102
Montclair, NJ 07042-2200
Phone (973) 965-8409

Other names 1

  • Malasa Jois Kahn Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 21, 2021 through Jan 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB10218700NJMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1184037079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VALLEY RD STE 102",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422200",
            "telephone_number": "973-965-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VALLEY RD STE 102",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422200",
            "telephone_number": "973-965-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "MALASA",
        "middle_name": "JOIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10218700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALASA",
            "last_name": "KAHN",
            "middle_name": "JOIS",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.