Individual provider Active NPI

Ralph Jason Kaye, D.M.D

  • Periodontics
  • Philadelphia, PA
National Provider Identifier
1629345418
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS025188-L Issued in PA
Practice address
3541 Ryan Ave
Philadelphia, PA 19136-4313
Phone
(215) 335-1889
NPI assigned
Nov 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS025188-L PA Primary

Addresses

Primary practice location

3541 Ryan Ave
Philadelphia, PA 19136-4313

Mailing address

3541 Ryan Ave
Philadelphia, PA 19136-4313
Phone (215) 335-1889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216000295 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729389788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS025188-LPAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfair Dental Associates LTD. Past Accepting new patients

Organizations & group practices 1

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": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1629345418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 RYAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191364313",
            "telephone_number": "215-335-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 RYAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191364313",
            "telephone_number": "215-335-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE",
        "first_name": "RALPH",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS025188-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.