Active NPI
Jason Peter Kahn, DO
- Family Medicine Physician
- Montclair, NJ
National Provider Identifier
1538572425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MB10203900
- Practice address
- 100 Valley Rd Ste 102
Montclair, NJ 07042-2200 - Phone
- (973) 965-8409
- Fax
- (973) 425-5673
- NPI assigned
- Jun 9, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MB10203900 | NJ | Primary |
Addresses
Primary practice location
100 Valley Rd Ste 102
Montclair, NJ 07042-2200
Mailing address
100 Valley Rd Ste 102
Montclair, NJ 07042-2200
Phone (973) 965-8409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 5, 2022 through Dec 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB10203900 | NJ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1538572425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 VALLEY RD STE 102",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422200",
"telephone_number": "973-965-8409",
"fax_number": "973-425-5673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 VALLEY RD STE 102",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422200",
"telephone_number": "973-965-8409",
"fax_number": "973-425-5673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "JASON",
"middle_name": "PETER",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-09",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MB10203900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.