Individual provider Active NPI

Kevin Leong, PA-C

  • Medical Physician Assistant
  • Newark, NJ
National Provider Identifier
1639500697
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00327400 Issued in NJ
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-5252
Fax
(973) 972-3144
NPI assigned
Dec 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00327400 NJ Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

185 S Orange Ave
MSB, H538
Newark, NJ 07103-2757
Phone (973) 972-5252

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808001327 NJ Practitioner - Physician Assistant 3577945534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

201 Lyons Ave
#L5
Newark, NJ 07112
Phone (973) 926-7161

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1639500697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "MSB, H538",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-5252",
            "fax_number": "973-972-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-5252",
            "fax_number": "973-972-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00327400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.