Individual provider Active NPI

Kiran Jalil, M.D

  • Pediatrics Physician
  • Bound Brook, NJ
National Provider Identifier
1639132400
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MAO6589800 Issued in NJ
Practice address
27 W Union Ave
Bound Brook, NJ 08805-1715
Phone
(732) 356-3737
Fax
(732) 356-6934
NPI assigned
Apr 11, 2006
Last updated
May 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MAO6589800 NJ Primary

Addresses

Primary practice location

27 W Union Ave
Bound Brook, NJ 08805-1715

Mailing address

27 W Union Ave
Bound Brook, NJ 08805-1715
Phone (732) 356-3737

Other identifiers 1

IdentifierTypeStateIssuer
7459700MedicaidNJ

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
I20050520000038 NJ Practitioner - Pediatric Medicine 1254372170 Practice locations: Bound Brook, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MAO6589800NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter's University Hospital Past Accepting new patients
Robert Wood Johnson University Hospital, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADCIBA/Endpoint/ADCIBA
  • Direct secure messaging: kjalil59170@epicdirect.rwjbh.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1639132400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 W UNION AVE",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051715",
            "telephone_number": "732-356-3737",
            "fax_number": "732-356-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 W UNION AVE",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051715",
            "telephone_number": "732-356-3737",
            "fax_number": "732-356-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALIL",
        "first_name": "KIRAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MAO6589800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7459700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bound Brook, NJ

Sources for this page

Verify at the official NPI Registry.