NPIMap

Individual provider Active NPI

Nicholas M Kaffl, PA-C

  • Surgical Physician Assistant
  • Livingston, NJ
National Provider Identifier
1669532909
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00021200 Issued in NJ
Practice address
200 S Orange Ave
Livingston, NJ 07039-5817
Phone
(973) 226-2725
NPI assigned
Dec 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00021200 NJ Primary

Addresses

Primary practice location

200 S Orange Ave
Livingston, NJ 07039-5817

Mailing address

1910 Snyder Ave
Belmar, NJ 07719-2642
Phone (856) 371-9113

Other practice location 1

901 W Main St
Freehold, NJ 07728-2549
Phone (732) 303-5114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000923 NJ Practitioner - Physician Assistant 5991608937 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

19 Davis Ave
Neptune, NJ 07753-4488

30 Prospect Ave
Hackensack, NJ 07601-1915

425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 836-4504

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00021200NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 6, 2023 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Nov 3, 2024 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Nov 3, 2024 Accepting new patients
Spine Bone and Joint Specialists LLC Past Accepting new patients

Locations

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

200 S Orange Ave
Livingston, NJ 07039
Phone (973) 322-7007

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Interoperability endpoints

  • Direct secure messaging: nkaffl261037@epicdirect.rwjbh.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 9

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1669532909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SNYDER AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192642",
            "telephone_number": "856-371-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "973-226-2725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 W Main St",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077282549",
            "country_code": "US",
            "telephone_number": "732-303-5114",
            "fax_number": "732-780-5473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAFFL",
        "first_name": "NICHOLAS",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00021200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.