Individual provider Active NPI

Kadejah Lawrence, PA-C

  • Physician Assistant
  • Oakhurst, NJ
National Provider Identifier
1356989701
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00548200 Issued in NJ
Practice address
1803 NJ-35
Oakhurst, NJ 07755
Phone
(732) 531-0100
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00548200 NJ Primary

Addresses

Primary practice location

1803 NJ-35
Oakhurst, NJ 07755

Mailing address

32 Broad St
Matawan, NJ 07747-2505

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
I20200124000010 NJ Practitioner - Physician Assistant 9931534765 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of NJ LLCGroup PAC ID 9638396849, 21 clinicians

Practice addresses (Care Compare)

2624 Hwy 516
Old Bridge, NJ 08857-2306
Phone (732) 952-5000

740 Route 1 N
Iselin, NJ 08830-2652
Phone (732) 874-5507

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MVP Medical Associates, PA CurrentSince Dec 17, 2019 Accepting new patients

Locations

200 Wyckoff Rd
Ste 1500
Eatontown, NJ 07724
Phone (732) 380-5456

1803 State Route 35
Oakhurst, NJ 07755
Phone (732) 695-3668

1851 Hooper Ave
Ste B1
Toms River, NJ 08753
Phone (732) 255-2001

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1356989701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 BROAD ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 NJ-35",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "07755",
            "telephone_number": "732-531-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "KADEJAH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00548200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, NJ

Sources for this page

Verify at the official NPI Registry.