NPIMap

Organization Active NPI

Kaleidoscope Medical Associates, PA

  • Family Medicine Physician
  • Phillipsburg, NJ
National Provider Identifier
1356377105
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB064321 Issued in NJ
Legal business name
KALEIDOSCOPE MEDICAL ASSOCIATES, PA
Practice address
410 Coventry Dr
Phillipsburg, NJ 08865-1978
Phone
(908) 454-9902
Fax
(908) 454-9905
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Dr. Ana P Gomes, D.O., CMDNPI 1750348900
Title
President
Phone
(908) 454-9902

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MB064321 NJ Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MB065920 NJ
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25MB077888000 NJ
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25MA06829400 NJ
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X NN095449NJ NJ

Addresses

Primary practice location

410 Coventry Dr
Phillipsburg, NJ 08865-1978

Mailing address

410 Coventry Centre Dr.
Phillipsburg, NJ 08865
Phone (908) 454-9902

Other identifiers 7

IdentifierTypeStateIssuer
7437307MedicaidNJ
8313407MedicaidNJ
7387601MedicaidNJ
0057908MedicaidNJ
119772OtherPAMEDICARE PA
8440506MedicaidNJ
041113OtherNJMEDICARE NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1356377105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 COVENTRY CENTRE DR.",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "08865",
            "telephone_number": "908-454-9902",
            "fax_number": "908-454-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 COVENTRY DR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651978",
            "telephone_number": "908-454-9902",
            "fax_number": "908-454-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSCOPE MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-454-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., CMD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB064321",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB065920",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB077888000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06829400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NN095449NJ",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7437307",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8313407",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7387601",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057908",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PA",
            "identifier": "119772",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8440506",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NJ",
            "identifier": "041113",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.