Individual provider Active NPI

Jay Kadhiwala, MD

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1265014765
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD486346 Issued in PA
Practice address
961 Marcon Blvd Ste 452
Allentown, PA 18109-9366
Phone
(484) 273-0908
Fax
(610) 347-5719
NPI assigned
Apr 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 MD486346 PA Primary

Addresses

Primary practice location

961 Marcon Blvd Ste 452
Allentown, PA 18109-9366

Mailing address

961 Marcon Blvd Ste 452
Allentown, PA 18109-9366
Phone (484) 273-0908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 20, 2024 through Aug 20, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486346PAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1265014765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD STE 452",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099366",
            "telephone_number": "484-273-0908",
            "fax_number": "610-347-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD STE 452",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099366",
            "telephone_number": "484-273-0908",
            "fax_number": "610-347-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADHIWALA",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD486346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.