Edison Nephrorlogy Consultants

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA64078 Issued in NJ

Legal business name

EDISON NEPHRORLOGY CONSULTANTS

Practice address

34-36 Progress Street
Suite A7
Edison, NJ 08820

Phone

(908) 769-1440

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Stanley Kim, M.D.NPI 1306850433

Title

Owner

Phone

(908) 769-1440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 4

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

• Stanley Kim, M.D.

  • Specialist
  • Edison, NJ
  • NPI 1306850433
  Medicare reassignment NPD Authorized official
• Ronald Cha, RN, ACNP-BC

  • Acute Care Clinical Nurse Specialist
  • Edison, NJ
  • NPI 1871914481
  Medicare reassignment NPD
• Angel C Sulse, MD

  • Internal Medicine Physician
  • Woodbridge, NJ
  • NPI 1982779054
  Medicare reassignment NPD
• Jeong In Park, PHARMACIST

  • Pharmacist
  • Fort Lee, NJ
  • NPI 1801484480
  NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306926159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34-36 PROGRESS STREET",
            "address_2": "SUITE A7",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "908-769-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34-36 PROGRESS STREET",
            "address_2": "SUITE A7",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "908-769-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON NEPHRORLOGY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-769-1440",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA64078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edison Medical Center LLC
• Edison Medical Health Care LLC
• Edison Medical Imaging
• Edison Medical Nutrition Center
• Edison Metuchen Orthopaedic Group PA
• Edison Neurologic Associates
• Edison Ophthalmology Associates L.L.C.
• Edison Optical Corporation
• Edison Optomeric
• Edison Orthopaedic Institute PA

• Specialist in Edison, NJ
• Providers in Edison, NJ by specialty
• Specialist in New Jersey

• 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.