NPIMap

Individual provider Active NPI

Kavin Chand, PA-C

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1518424696
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00588100 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
Feb 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5257 CT
Physician Assistant 363A00000X PA12703 TX
Physician Assistant 363A00000X 25MP00588100 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

3600 Route 66
FL 3
Neptune, NJ 07753-2645
Phone (732) 807-0877

Other practice location 1

801 E Nolana Ave Ste 15
McAllen, TX 78504-6112
Phone (956) 683-0404

Other practice location 2

4302 S Sugar Rd Ste 201
Edinburg, TX 78539
Phone (956) 603-1333

Other names 1

  • Kavinchand Sivagurunathan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CT, NY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201216000178 NJ Practitioner - Physician Assistant 6709129745 Reassigns benefits to 2 organizations
I20210901000457 CT Practitioner - Physician Assistant 6709129745 Reassigns benefits to 1 organization
I20230215000903 NY Practitioner - Physician Assistant 6709129745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5257CTMDClinical Social Worker
25MP00588100NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc CurrentSince Aug 29, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 1, 2020 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Aug 29, 2021 Accepting new patients
Juan Joel Garza, MD PA Past Accepting new patients
McAllen Hospitals L P Past Accepting new patients
Socrates a Garrigos, Mdpa PastSince Sep 29, 2019 Accepting new patients
Meridian Medical Group - Specialty Care, PC Past Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: kavinchand@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 10

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 1

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1518424696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66",
            "address_2": "FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Nolana Ave Ste 15",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785046112",
            "country_code": "US",
            "telephone_number": "956-683-0404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4302 S Sugar Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "78539",
            "country_code": "US",
            "telephone_number": "956-603-1333",
            "fax_number": "956-380-4433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAND",
        "first_name": "KAVIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5257",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12703",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00588100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAVINCHAND",
            "last_name": "SIVAGURUNATHAN",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.