Organization Active NPI

Kidney Care of Morris County LLC

  • Nephrology Physician
  • Morristown, NJ
National Provider Identifier
1396265708
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA08385900 Issued in NJ
Legal business name
KIDNEY CARE OF MORRIS COUNTY LLC
Practice address
290 Madison Ave BLDG No5 2ND Floor
Morristown, NJ 07960-7401
Phone
(973) 631-6223
Fax
(973) 631-6225
NPI assigned
Jun 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Shubho Sarkar, MDNPI 1932375581
Title
Owner
Phone
(973) 631-6223

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 25MA08385900 NJ
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 25MA08385900 NJ Primary

Addresses

Primary practice location

290 Madison Ave BLDG No5 2ND Floor
Morristown, NJ 07960-7401

Mailing address

290 Madison Ave BLDG No 5, 2ND Floor
Morristown, NJ 07960-7401
Phone (973) 631-6223

Other identifiers 1

IdentifierTypeStateIssuer
0164674MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170816001793 NJ Part B Supplier - Clinic/Group Practice 8022380799 Receives reassigned benefits from 10 practitioners
Practice locations: Morristown, NJ; Martinsville, NJ; Hackettstown, NJ; Denville, NJ

National Provider Directory

National Provider Directory

Locations

57 US Highway 46
Ste 201
Hackettstown, NJ 07840
Phone (908) 441-7201

290 Madison Ave
Ste 2
Morristown, NJ 07960
Phone (201) 704-7578

131 Madison Ave
Ste 3
Morristown, NJ 07960
Phone (973) 326-9000

290 Madison Ave
Bldg NO52
Morristown, NJ 07960

290 Madison Ave
Bldg NO5
Morristown, NJ 07960

900 Lanidex Plz
Ste 120
Parsippany, NJ 07054
Phone (973) 739-7080

Practitioners & affiliated clinicians

Practitioners 12

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": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1396265708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE BLDG NO 5, 2ND FLOOR",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607401",
            "telephone_number": "973-631-6223",
            "fax_number": "973-631-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE BLDG NO5 2ND FLOOR",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607401",
            "telephone_number": "973-631-6223",
            "fax_number": "973-631-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE OF MORRIS COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "SARKAR",
        "authorized_official_first_name": "SHUBHO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-631-6223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08385900",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08385900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164674",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.