Individual provider Active NPI

Randolph Kahn, M.D.

  • Anesthesiology Physician
  • Union, NJ
National Provider Identifier
1235122144
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MB06083300 Issued in NY
Practice address
695 Chestnut St
Union, NJ 07083-7200
Phone
(908) 851-7161
NPI assigned
Aug 25, 2005
Last updated
Mar 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MB06083300 NY Primary

Addresses

Primary practice location

695 Chestnut St
Union, NJ 07083-7200

Mailing address

695 Chestnut St
Union, NJ 07083-7200

Other identifiers 1

IdentifierTypeStateIssuer
6408605MedicaidNJ

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
I20090602000095 NJ Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 7416942347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06083300NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Anesthesia Associates, PA Anesthesiology CurrentSince Oct 13, 1994 Accepting new patients

Locations

1931 Oak Tree Rd
Edison, NJ 08820
Phone (732) 482-9600

695 Chestnut St
Union, NJ 07083
Phone (908) 688-6565

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, 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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1235122144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837200",
            "telephone_number": "908-851-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "RANDOLPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "25MB06083300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6408605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.