Individual provider Active NPI

Kevin Jerren Hosein, M.D.

  • Cardiovascular Disease Physician
  • Fair Lawn, NJ
National Provider Identifier
1245614692
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA10746700 Issued in NJ
Practice address
22-18 Broadway Ste 104
Fair Lawn, NJ 07410-3016
Phone
(201) 773-0887
Fax
(201) 797-8877
NPI assigned
Jul 15, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA10746700 NJ Primary

Addresses

Primary practice location

22-18 Broadway Ste 104
Fair Lawn, NJ 07410-3016

Mailing address

22-18 Broadway Ste 201
Fair Lawn, NJ 07410-3016
Phone (201) 475-5050

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
I20210811004030 NJ Practitioner - Cardiovascular Disease (Cardiology) 6103220207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Suite 201
Fair Lawn, NJ 07410-3016
Phone (201) 475-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10746700NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Sep 20, 2021 Accepting new patients
Englewood Hospital and Medical Center Past Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-18 Broadway
Ste 202
Fair Lawn, NJ 07410
Phone (201) 796-5400

22-18 Broadway
Ste 201
Fair Lawn, NJ 07410

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

22-18 Broadway
Ste 104
Fair Lawn, NJ 07410
Phone (201) 797-4503

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

342 Hamburg Tpke
Ste 208
Wayne, NJ 07470
Phone (973) 790-5357

1225 McBride Ave
Ste 223
Woodland Park, NJ 07424
Phone (973) 595-5345

1225 McBride Ave
Ste 222
Woodland Park, NJ 07424
Phone (973) 852-1353

Organizations & group practices 2

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 4

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1245614692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY STE 201",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "201-475-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY STE 104",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "201-773-0887",
            "fax_number": "201-797-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSEIN",
        "first_name": "KEVIN",
        "middle_name": "JERREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA10746700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.