Organization Active NPI

Cholankeril Medical Associates MD LLC

  • Cardiovascular Disease Physician
  • Elizabeth, NJ
National Provider Identifier
1467508457
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA042045 Issued in NJ
Legal business name
CHOLANKERIL MEDICAL ASSOCIATES MD LLC
Practice address
100 Grove St
Elizabeth, NJ 07202-1111
Phone
(908) 352-1738
Fax
(908) 820-0966
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Dr. Mathew Cholankeril, MDNPI 1588694780
Title
Partner
Phone
(908) 352-1738

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X MA042045 NJ Primary

Addresses

Primary practice location

100 Grove St
Elizabeth, NJ 07202-1111

Mailing address

100 Grove St
Elizabeth, NJ 07202-1111
Phone (908) 352-1738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000013 NJ Part B Supplier - Clinic/Group Practice 7416922562 Receives reassigned benefits from 4 practitioners
Practice locations: Elizabeth, NJ; Rahway, NJ

National Provider Directory

National Provider Directory

Locations

100 Grove St
Elizabeth, NJ 07202
Phone (908) 352-1735

1600 Saint Georges Ave
Ste 106
Rahway, NJ 07065
Phone (732) 382-2177

1507 Saint Georges Ave
Rahway, NJ 07065
Phone (732) 382-2177

Practitioners & affiliated clinicians

Practitioners 4

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1467508457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GROVE ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021111",
            "telephone_number": "908-352-1738",
            "fax_number": "908-820-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GROVE ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021111",
            "telephone_number": "908-352-1738",
            "fax_number": "908-820-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOLANKERIL MEDICAL ASSOCIATES MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "CHOLANKERIL",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "908-352-1738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA042045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.