Individual provider Active NPI

Kevin S Brown, PA

  • Surgical Physician Assistant
  • Tinton Falls, NJ
National Provider Identifier
1316924251
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MP00777 Issued in NJ
Practice address
776 Shrewsbury Ave
Suite 201
Tinton Falls, NJ 07724-3006
Phone
(732) 530-4949
Fax
(732) 530-3618
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MP00777 NJ Primary

Addresses

Primary practice location

776 Shrewsbury Ave
Suite 201
Tinton Falls, NJ 07724-3006

Mailing address

776 Shrewsbury Ave
Suite 201
Tinton Falls, NJ 07724-3006
Phone (732) 530-4949

Other identifiers 1

IdentifierTypeStateIssuer
222606262OtherNJHORIZON BCBS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000401 NJ Practitioner - Physician Assistant 5991989212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

776 Shrewsbury Ave
Tinton Falls, NJ 07724-4507
Phone 7325304949240

776 Shrewsbury Ave
Suite 102
Tinton Falls, NJ 07724-3006
Phone (732) 590-4949

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MP00777NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Orthopaedic Assoc PA CurrentSince Jan 4, 2002 Accepting new patients

Locations

776 Shrewsbury Ave
Ste 201
Tinton Falls, NJ 07724
Phone (732) 530-4949

776 Shrewsbury Ave
Ste 105
Tinton Falls, NJ 07724
Phone (732) 530-4949

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1316924251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 SHREWSBURY AVE",
            "address_2": "SUITE 201",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243006",
            "telephone_number": "732-530-4949",
            "fax_number": "732-212-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 SHREWSBURY AVE",
            "address_2": "SUITE 201",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243006",
            "telephone_number": "732-530-4949",
            "fax_number": "732-530-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KEVIN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "MP00777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BCBS",
            "identifier": "222606262",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

Verify at the official NPI Registry.