Individual provider Active NPI

Kalanie Mendis, M.D.

  • Internal Medicine Physician
  • Trenton, NJ
National Provider Identifier
1407053291
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08631100 Issued in NJ
Practice address
750 Brunswick Ave
Trenton, NJ 08638-4143
Phone
(609) 394-7374
NPI assigned
Jun 27, 2007
Last updated
Jan 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08631100 NJ Primary

Addresses

Primary practice location

750 Brunswick Ave
Trenton, NJ 08638-4143

Mailing address

PO Box 8500-1611
Philadelphia, PA 19178-0001
Phone (609) 815-7810

Other identifiers 1

IdentifierTypeStateIssuer
0215821MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100121000219 NJ Practitioner - NephrologyPractitioner - Internal Medicine 3173665635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Forrestal Rd S
Suite 100
Princeton, NJ 08540-6666
Phone (732) 301-4767

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08631100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Kidney Care LLC CurrentSince Feb 1, 2014 Accepting new patients
Capital Health System Internal Medicine Past Accepting new patients

Locations

10 Forrestal Rd S
Ste 100
Princeton, NJ 08540
Phone (732) 301-4767

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1407053291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-1611",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "609-815-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BRUNSWICK AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384143",
            "telephone_number": "609-394-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIS",
        "first_name": "KALANIE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08631100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215821",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.