Individual provider Active NPI

Christana Shamrock-Kmecz, PA

  • Medical Physician Assistant
  • Holmdel, NJ
National Provider Identifier
1205881349
Registry record updated Jul 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00046400 Issued in NJ
Practice address
23 Main St Ste D1
Holmdel, NJ 07733-2136
Phone
(732) 571-1000
Fax
(732) 571-1156
NPI assigned
May 24, 2006
Last updated
Jul 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00046400 NJ Primary

Addresses

Primary practice location

23 Main St Ste D1
Holmdel, NJ 07733-2136

Mailing address

23 Main St Ste D1
Holmdel, NJ 07733-2136
Phone (732) 571-1000

Other names 1

  • Christana Kmecz Former name

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
I20041206000396 NJ Practitioner - Physician Assistant 8527024199 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rutgers New Jersey Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VPS Medical Services, PCGroup PAC ID 2961836069, 45 clinicians

Practice addresses (Care Compare)

3600 State Route 66
Neptune, NJ 07753-2645

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Nurse Association of Central Jersey, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Atlantic Professional Services of New Jersey, P.a. Past Accepting new patients

Locations

23 Main St
#D1
Holmdel, NJ 07733
Phone (732) 224-6914

176 Riverside Ave
Red Bank, NJ 07701
Phone (732) 224-6914

1100 Wayside Rd
Tinton Falls, NJ 07712
Phone (732) 493-2220

3600 State Route 66
Fl 4
Tinton Falls, NJ 07753
Phone (732) 241-4194

Interoperability endpoints

  • Direct secure messaging: christana.shamrockkmecz.p2@direct.vnahg.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1205881349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MAIN ST STE D1",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332136",
            "telephone_number": "732-571-1000",
            "fax_number": "732-571-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MAIN ST STE D1",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332136",
            "telephone_number": "732-571-1000",
            "fax_number": "732-571-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMROCK-KMECZ",
        "first_name": "CHRISTANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00046400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTANA",
            "last_name": "KMECZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.