Princeton Kidney Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA08631100 Issued in NJ

Legal business name

PRINCETON KIDNEY CARE LLC

Practice address

10 Forrestal Road South
Suite 100
Princeton, NJ 08540

Phone

(908) 787-5103

Fax

(732) 641-2043

NPI assigned

Nov 21, 2013

Organization subpart

No

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

Authorized official

Name

Kalanie Mendis, MDNPI 1407053291

Title

Owner

Phone

(908) 787-5103

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kalanie Mendis, M.D.

  • Internal Medicine Physician
  • Trenton, NJ
  • NPI 1407053291
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1265862619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7475",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088317474",
            "telephone_number": "908-787-5103",
            "fax_number": "732-641-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FORRESTAL ROAD SOUTH",
            "address_2": "SUITE 100",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "908-787-5103",
            "fax_number": "732-641-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-21",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "MENDIS",
        "authorized_official_first_name": "KALANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-787-5103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08631100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215821",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Princeton House Provider Group LLC
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• Princeton Integrative Wellness LLC
• Princeton Internal Medicine and Geriatrics LLC
• Princeton Interventional Cardiology PA
• Princeton Longevity Medical GRP LLC
• Princeton Medical Group,P.a.
• Princeton Medical Pharmacy LLC
• Princeton Natural Health Care Associates
• Princeton Neonatology Group

• Nephrology Physician in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.