NPIMap

Individual provider Active NPI

Yisrael Kadosh, MD

  • Cardiovascular Disease Physician
  • Lakewood, NJ
National Provider Identifier
1417917907
Registry record updated Nov 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA08048100 Issued in NJ
Practice address
637 River Ave
Lakewood, NJ 08701-5227
Phone
(732) 597-3953
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA08048100 NJ Primary
Cardiovascular Disease Physician 207RC0000X 224727 NY
Cardiovascular Disease Physician 207RC0000X MD438811 PA

Addresses

Primary practice location

637 River Ave
Lakewood, NJ 08701-5227

Mailing address

637 River Ave
Lakewood, NJ 08701-5227
Phone (732) 597-3953

Other identifiers 1

IdentifierTypeStateIssuer
0287164MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060609000016 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2062424146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

637 River Ave
Lakewood, NJ 08701-5227
Phone (732) 504-8312

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.37 of 100Reported as individual
Quality
69.88
Promoting interoperability
86
Improvement activities
40
Cost
65.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224727NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office Force Cardiovascular Disease CurrentSince Oct 1, 2022 Accepting new patients
Fastrad LLC CurrentSince Aug 25, 2008 Accepting new patients
Lakewood Cardiology LLC Cardiovascular Disease CurrentSince Nov 1, 2016 Accepting new patients
Petronilo L Seares Jr MD LLC Cardiovascular Disease PastSince Sep 1, 2008 Accepting new patients
Monmouth Medical Center Inc Past Accepting new patients

Locations

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

35 Beaverson Blvd
Ste 7B
Brick, NJ 08723
Phone (732) 262-2400

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

637 River Ave
Lakewood, NJ 08701
Phone (732) 597-3953

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479945600000",
    "number": "1417917907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015227",
            "telephone_number": "732-597-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015227",
            "telephone_number": "732-597-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADOSH",
        "first_name": "YISRAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08048100",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "224727",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD438811",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287164",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.