Kidkare Medical PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

25MA07639000 Issued in NJ

Legal business name

KIDKARE MEDICAL PA

Practice address

15-01 Broadway Ste 36
Fair Lawn, NJ 07410-6006

Phone

(201) 773-6171

Fax

(201) 773-4845

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Irina Bass, MDNPI 1346212156

Title

Pediatrician

Phone

(201) 773-6171

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Irina Bass, MD

  • Pediatrics Physician
  • Fair Lawn, NJ
  • NPI 1346212156
  Authorized official Same address or phone

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1386856029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY STE 36",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106006",
            "telephone_number": "201-773-6171",
            "fax_number": "201-773-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY STE 36",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106006",
            "telephone_number": "201-773-6171",
            "fax_number": "201-773-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDKARE MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "201-773-6171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "25MA07639000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081787",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1346212156",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bassam Khalil, PHARMD
• Nosheen Khawaja
• Shivani Khetani, MD
• Matthew Chieng Khowong, PHARM.D
• Mark L Khurgin, PT
• Bethany Killian, CCC-SLP
• Dong Hyun Kim, OD
• Hyo Jung J Kim, PHARM-D
• Jane J Kim, PHARMD
• Erica R King, MS, CCC-SLP

• Clinic/Center in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.