Individual provider Active NPI

John Kindzierski III, MD

  • Obstetrics & Gynecology Physician
  • Livingston, NJ
National Provider Identifier
1396811485
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MA033756 Issued in NJ
Practice address
94 Old Short Hills Rd
Suite 3148
Livingston, NJ 07039-5672
Phone
(973) 322-5669
Fax
(973) 533-4492
NPI assigned
Nov 28, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA033756 NJ Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Suite 3148
Livingston, NJ 07039-5672

Mailing address

94 Old Short Hills Rd
Suite 3148
Livingston, NJ 07039-5672
Phone (973) 322-5669

Other identifiers 5

IdentifierTypeStateIssuer
0927031OtherAETNA
1K3470OtherPHS
2243091OtherAETNA
P67168352OtherMULTIPLAN
EP165OtherOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA033756NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Womens Healthcare PA Obstetrics & Gynecology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1396811485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "address_2": "SUITE 3148",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5669",
            "fax_number": "973-533-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "address_2": "SUITE 3148",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5669",
            "fax_number": "973-533-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDZIERSKI",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA033756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0927031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "1K3470",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2243091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "P67168352",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "EP165",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.