NPIMap

Organization Active NPI

Tri State Nephrologists LLC

  • Nephrology Physician
  • Salem, NJ
National Provider Identifier
1538514666
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
TRI STATE NEPHROLOGISTS LLC
Practice address
5 Route 45 Ste 101
Salem, NJ 08079-2000
Phone
(856) 887-3005
NPI assigned
Apr 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Richard Kasama, M.D.NPI 1912095647
Title
Doctor
Phone
(856) 887-3005

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
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

5 Route 45 Ste 101
Salem, NJ 08079-2000

Mailing address

5 Route 45 Ste 101
Salem, NJ 08079-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181105000267 NJ Part B Supplier - Clinic/Group Practice 1456620012 Receives reassigned benefits from 4 practitioners
Practice locations: Salem, NJ

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1538514666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ROUTE 45 STE 101",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080792000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ROUTE 45 STE 101",
            "city": "SALEM",
            "state": "NJ",
            "postal_code": "080792000",
            "telephone_number": "856-887-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE NEPHROLOGISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "KASAMA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "856-887-3005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.