Organization Active NPI

Summit Cardiology, LLC

  • Cardiovascular Disease Physician
  • Summit, NJ
National Provider Identifier
1285729806
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SUMMIT CARDIOLOGY, LLC
Practice address
One Springfield Ave. Ste. 2a
Summit, NJ 07901-4055
Phone
(908) 273-1999
Fax
(908) 273-1332
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark J Krell, MDNPI 1558456822
Title
Owner
Phone
(908) 273-1999

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

One Springfield Ave. Ste. 2a
Summit, NJ 07901-4055

Mailing address

One Springfield Ave. Ste. 2a
Summit, NJ 07901-4055
Phone (908) 273-1999

Other identifiers 2

IdentifierTypeStateIssuer
DA9581OtherNJRAILROAD MEDICARE
0094838MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000056 NJ Part B Supplier - Clinic/Group Practice 2961315429 Receives reassigned benefits from 2 practitioners
Practice locations: Summit, NJ

National Provider Directory

National Provider Directory

Locations

1 Springfield Ave
Ste 2A
Summit, NJ 07901
Phone (908) 273-1999

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285729806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE SPRINGFIELD AVE. STE. 2A",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014055",
            "telephone_number": "908-273-1999",
            "fax_number": "908-273-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE SPRINGFIELD AVE. STE. 2A",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014055",
            "telephone_number": "908-273-1999",
            "fax_number": "908-273-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CARDIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-273-1999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA9581",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094838",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.