Individual provider Active NPI

Costas A Kaiafas, MD

  • Emergency Medicine Physician
  • Berkeley Heights, NJ
National Provider Identifier
1528057866
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA68406 Issued in NJ
Practice address
1 Diamond Hill Rd
Summit Medical Group
Berkeley Heights, NJ 07922-2104
Phone
(908) 273-4300
Fax
(908) 790-6524
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA06840600 NJ
Emergency Medicine Physician 207P00000X MA68406 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd
Summit Medical Group
Berkeley Heights, NJ 07922-2104

Mailing address

1 Diamond Hill Rd
Summit Medical Group
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other identifiers 1

IdentifierTypeStateIssuer
8073902MedicaidNJ

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
I20090112000223 NJ Practitioner - Emergency Medicine 6800959289 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA68406NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Office of Brick CurrentSince Feb 5, 2014 Accepting new patients
Barron Emergency Physicians LLC Emergency Medicine CurrentSince Jul 10, 2018 Accepting new patients
Union Emergency Medical Associates LLC Emergency Medicine PastSince Jan 19, 2025 Accepting new patients

Locations

1945 Corlies Ave
#33
Neptune City, NJ 07753
Phone (732) 776-4203

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1528057866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "address_2": "SUMMIT MEDICAL GROUP",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300",
            "fax_number": "908-790-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "address_2": "SUMMIT MEDICAL GROUP",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300",
            "fax_number": "908-790-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIAFAS",
        "first_name": "COSTAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06840600",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA68406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8073902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.