Active NPI
Costas A Kaiafas, MD
- Emergency Medicine Physician
- Berkeley Heights, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MA68406
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8073902 | Medicaid | NJ |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA68406 | NJ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctors Office of Brick | Current | Accepting new patients | |
| Barron Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Union Emergency Medical Associates LLC | Emergency Medicine | Past | 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.
-
- Emergency Medicine Physician
- Manahawkin, NJ
- NPI 1790736940
-
- Urgent Care Clinic/Center
- Brick, NJ
- NPI 1184067944
-
- Emergency Medicine Physician
- Union, NJ
- NPI 1689847352
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.