Individual provider Active NPI

Kevin Edmond Crutchfield, MD

  • Vascular Neurology Physician
  • Hackensack, NJ
National Provider Identifier
1578680914
Registry record updated Apr 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
25MA08248800 Issued in NJ
Practice address
360 Essex St
Hackensack, NJ 07601-8550
Phone
(551) 996-8100
Fax
(551) 996-4140
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA08248800 NJ
Neurology Physician 2084N0400X 0101044892 VA
General Practice Physician 208D00000X 0101044892 VA
Vascular Neurology Physician 2084V0102X 25MA08248800 NJ Primary

Addresses

Primary practice location

360 Essex St
Hackensack, NJ 07601-8550

Mailing address

12513 Bracken Hill LN
Potomac, MD 20854-1116
Phone (410) 601-9515

Other practice location 1

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Other practice location 2

125A Medical Cir
Winchester, VA 22601-3322
Phone (540) 667-1828

Other practice location 3

12200 Warwick Blvd Ste 110
Newport News, VA 23601-2344
Phone (757) 534-5100

Other practice location 4

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2000

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
I20070726000474 NJ Practitioner - Neurology 9830290428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

360 Essex St
Hackensack, NJ 07601-8550
Phone (201) 336-8686

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08248800NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 15, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 15, 2022 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

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

360 Essex St
Hackensack, NJ 07601
Phone (201) 336-8686

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

650 From Rd
Paramus, NJ 07652
Phone (201) 639-6620

Interoperability endpoints

  • Direct secure messaging: kcrutchfield864340@ahs.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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 4

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650758400000",
    "number": "1578680914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12513 BRACKEN HILL LN",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541116",
            "telephone_number": "410-601-9515",
            "fax_number": "410-601-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018550",
            "telephone_number": "551-996-8100",
            "fax_number": "551-996-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125A Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226013322",
            "country_code": "US",
            "telephone_number": "540-667-1828",
            "fax_number": "540-722-6207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12200 Warwick Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236012344",
            "country_code": "US",
            "telephone_number": "757-534-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 J Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-594-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "KEVIN",
        "middle_name": "EDMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-04-24",
        "certification_date": "2022-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA08248800",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101044892",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101044892",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NJ",
            "license": "25MA08248800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.