Individual provider Active NPI

Kevin J Kargman, D.O.

  • Pediatrics Physician
  • Sewell, NJ
National Provider Identifier
1407810302
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MB069151 Issued in NJ
Practice address
438 Ganttown Rd Ste A7
Sewell, NJ 08080-1886
Phone
(856) 589-0011
Fax
(856) 589-5015
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MB069151 NJ Primary

Addresses

Primary practice location

438 Ganttown Rd Ste A7
Sewell, NJ 08080-1886

Mailing address

23 N Delsea Dr Unit B
Clayton, NJ 08312-1637
Phone (856) 423-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190930001002 NJ Practitioner - Pediatric Medicine 8123358470 Reassigns benefits to 1 organization
I20220222000541 FL Practitioner - General Practice 8123358470

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB069151NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Pediatric Assoc, LLC Pediatrics CurrentSince Jul 14, 2019 Accepting new patients

Locations

23 N Delsea Dr
#B
Clayton, NJ 08312
Phone (856) 226-4852

438 Ganttown Rd
Ste A7
Sewell, NJ 08080
Phone (856) 582-8100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1407810302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 N DELSEA DR UNIT B",
            "city": "CLAYTON",
            "state": "NJ",
            "postal_code": "083121637",
            "telephone_number": "856-423-7700",
            "fax_number": "856-423-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 GANTTOWN RD STE A7",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801886",
            "telephone_number": "856-589-0011",
            "fax_number": "856-589-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARGMAN",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MB069151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.