NPIMap

Organization Active NPI

Kane Medical LLC

  • Dermatology Physician
  • Somers Point, NJ
National Provider Identifier
1417465741
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA09419800 Issued in NJ
Legal business name
KANE MEDICAL LLC
Practice address
223 Shore Rd
Somers Point, NJ 08244-2631
Phone
(609) 705-7546
NPI assigned
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Kelly Rose Kane, MDNPI 1497776579
Title
Owner
Phone
(215) 380-6061

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 25MA09419800 NJ Primary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X 25MA09419800 NJ

Addresses

Primary practice location

223 Shore Rd
Somers Point, NJ 08244-2631

Mailing address

223 Shore Rd
Somers Point, NJ 08244-2631
Phone (609) 705-7546

Other names 1

  • Kane Dermatology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180327000190 NJ Part B Supplier - Clinic/Group Practice 3274895560 Receives reassigned benefits from 4 practitioners
Practice locations: Somers Point, NJ

National Provider Directory

National Provider Directory

Locations

235 Shore Rd
Ste C
Somers Point, NJ 08244
Phone (609) 705-7546

Practitioners & affiliated clinicians

Practitioners 6

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1417465741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442631",
            "telephone_number": "609-705-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442631",
            "telephone_number": "609-705-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-380-6061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA09419800",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": "25MA09419800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kane Dermatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Somers Point, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.