Individual provider Active NPI

Kevin T Nini, M.D.

  • Plastic Surgery Physician
  • New Brunswick, NJ
National Provider Identifier
1194747964
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MA057354 Issued in NJ
Practice address
409 Joyce Kilmer Ave Ste 210
New Brunswick, NJ 08901
Phone
(732) 418-0709
Fax
(732) 418-0747
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MA057354 NJ Primary

Addresses

Primary practice location

409 Joyce Kilmer Ave Ste 210
New Brunswick, NJ 08901

Mailing address

409 Joyce Kilmer Ave Ste 210
New Brunswick, NJ 08901-3363
Phone (732) 418-0709

Other identifiers 1

IdentifierTypeStateIssuer
MA057354OtherNJLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057354NJMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Plastic and Reconstructive Surgeons of Central Jersey PA Past Accepting new patients

Organizations & group practices 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1194747964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 JOYCE KILMER AVE STE 210",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013363",
            "telephone_number": "732-418-0709",
            "fax_number": "732-418-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 JOYCE KILMER AVE STE 210",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-418-0709",
            "fax_number": "732-418-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINI",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "MA057354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MA057354",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.