Individual provider Active NPI

Maxim Vsevolodovich Kashin

  • Pulmonary Disease Physician
  • Englewood, NJ
National Provider Identifier
1467911404
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA12808100 Issued in NJ
Practice address
200 Grand Ave Ste 102
Englewood, NJ 07631-4363
Phone
(201) 871-3636
Fax
(201) 871-8987
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 25MA12808100 NJ Primary

Addresses

Primary practice location

200 Grand Ave Ste 102
Englewood, NJ 07631-4363

Mailing address

3 University PLZ Ste 205
Hackensack, NJ 07601-6208
Phone (201) 833-3599

Other practice location 1

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 871-3636

Other practice location 2

8305 Bergenline Ave Ste A
North Bergen, NJ 07047-5057
Phone (201) 854-7200

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
I20250917003304 NJ Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 5294239836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Name Pulmonary Associates PCGroup PAC ID 2466514674, 15 clinicians

Practice addresses (Care Compare)

200 Grand Ave
Suite 102
Englewood, NJ 07631-4363
Phone (201) 871-3636

Hospital & facility affiliations

  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Name Pulmonary Associates, PC Pulmonary Disease CurrentSince Oct 1, 2025 Accepting new patients

Locations

200 Grand Ave
Ste 102
Englewood, NJ 07631
Phone (201) 481-7160

3 University Plz
Ste 205
Hackensack, NJ 07601

8305 Bergenline Ave
Ste A
North Bergen, NJ 07047
Phone (201) 854-7200

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

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.

Hospital & facility affiliations 3

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1467911404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3599",
            "fax_number": "201-227-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 102",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363",
            "telephone_number": "201-871-3636",
            "fax_number": "201-871-8987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Teaneck Rd",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076664245",
            "country_code": "US",
            "telephone_number": "201-871-3636",
            "fax_number": "201-871-8987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8305 Bergenline Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070475057",
            "country_code": "US",
            "telephone_number": "201-854-7200",
            "fax_number": "201-854-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASHIN",
        "first_name": "MAXIM",
        "middle_name": "VSEVOLODOVICH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA12808100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.