Organization Active NPI

Cornerstone Family Care LLC

  • Family Medicine Physician
  • Edison, NJ
National Provider Identifier
1215548698
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNERSTONE FAMILY CARE LLC
Practice address
1921 Oak Tree Rd Ste 103
Edison, NJ 08820-2073
Phone
(732) 242-4222
Fax
(732) 242-4170
NPI assigned
Aug 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Dr. Paul Kang, MDNPI 1760902100
Title
Physician
Phone
(732) 242-4222

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1921 Oak Tree Rd Ste 103
Edison, NJ 08820-2073

Mailing address

1921 Oak Tree Rd Ste 103
Edison, NJ 08820-2073
Phone (732) 242-4222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200922000755 NJ Part B Supplier - Clinic/Group Practice 3072931104 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2190238Cornerstone Family Care LLC1921 Oak Tree Road, Suite 103, Edison, NJ 08820Certificate of waiverAug 10, 2026

National Provider Directory

National Provider Directory

Locations

1921 Oak Tree Rd
Ste 103
Edison, NJ 08820
Phone (732) 242-4222

Practitioners & affiliated clinicians

Practitioners 1

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": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1215548698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 OAK TREE RD STE 103",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202073",
            "telephone_number": "732-242-4222",
            "fax_number": "732-242-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 OAK TREE RD STE 103",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202073",
            "telephone_number": "732-242-4222",
            "fax_number": "732-242-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2022-06-02",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-242-4222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.