Individual provider Active NPI

Kathyann S Duncan, M.D.

  • Family Medicine Physician
  • Vauxhall, NJ
National Provider Identifier
1215049630
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA06382900 Issued in NJ
Practice address
3 Farrington St
Vauxhall, NJ 07088-1307
Phone
(908) 868-8904
Fax
(973) 762-4955
NPI assigned
Aug 31, 2006
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 25MA06382900 NJ Primary

Addresses

Primary practice location

3 Farrington St
Vauxhall, NJ 07088-1307

Mailing address

2040 Millburn Ave
Suite 303
Maplewood, NJ 07040-3726
Phone (973) 762-4944

Other identifiers 1

IdentifierTypeStateIssuer
7288301MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000281 NJ Practitioner - Family Practice 5597806380

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2040 Millburn Ave
Maplewood, NJ 07040-3716

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06382900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Family Medicine Past Accepting new patients
Calvary Medical Associates LLC PastSince Jul 1, 2009 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vsfm@vsfm-nj.direct.office.nextgen.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1215049630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE",
            "address_2": "SUITE 303",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403726",
            "telephone_number": "973-762-4944",
            "fax_number": "973-762-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FARRINGTON ST",
            "city": "VAUXHALL",
            "state": "NJ",
            "postal_code": "070881307",
            "telephone_number": "908-868-8904",
            "fax_number": "973-762-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "KATHYANN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06382900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7288301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vauxhall, NJ

Sources for this page

Verify at the official NPI Registry.