Pryiesh T Thakkar, DO MBA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MB07722800 Issued in NJ

Practice address

510 Jackson Ave
Northfield, NJ 08225

Phone

(609) 383-0200

Fax

(609) 383-8352

NPI assigned

Aug 5, 2006

Last updated

Oct 26, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

NephrologyAlso: Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlanticare Health Services, Inc.Group PAC ID 7911810916, 56 clinicians

Northeast Kidney Care LLCGroup PAC ID 8921445032, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC Pomona Dialysis facility, Galloway, NJ, CCN 312611
• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064
• Shore Medical Center Hospital, Somers Point, NJ, CCN 310047
• Cape Regional Medical Center Inc Hospital, Cape May Court House, NJ, CCN 310011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Business Administration

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pthakkar25457@direct.acumenmd.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315

  Corporate Director

  CMS ownership

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.

• Atlanticare Health Services, Inc.

  • Clinic/Center
  • Atlantic City, NJ
  • NPI 1215987771
  Medicare reassignment Care Compare group NPD
• Northeast Kidney Care LLC

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1023889565

  Nephrology

  Medicare reassignment Care Compare group NPD
• Regional Nephrology Associates, P.a.

  • Nephrology Physician
  • Northfield, NJ
  • NPI 1982613113
  Medicare reassignment NPD
• Atlanticare Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Egg Harbor Township, NJ
  • NPI 1407617947
  NPD
• Atlanticare Health Services Inc.

  dba AtlantiCare Mission Health Care Galloway

  • Federally Qualified Health Center (FQHC)
  • Galloway, NJ
  • NPI 1043700495
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresenius Medical Care Pomona LLC

  dba Fresenius Medical Care Pomona

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Galloway, NJ
  • NPI 1184916629

  Dialysis facility

  Care Compare affiliation Name & address match
• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation
• Cooper University Hospital Cape Regional Inc

  • General Acute Care Hospital
  • Cape May Court House, NJ
  • NPI 1053382697
  Care Compare affiliation
• Shore Memorial Hospital

  • General Acute Care Hospital
  • Somers Point, NJ
  • NPI 1629070149
  Care Compare affiliation

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1689683815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 JACKSON AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "08225",
            "telephone_number": "609-383-0200",
            "fax_number": "609-383-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 JACKSON AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "08225",
            "telephone_number": "609-383-0200",
            "fax_number": "609-383-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "PRYIESH",
        "middle_name": "T",
        "credential": "DO MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MB07722800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068951",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Tangradi, MS, LAC, LCADC
• Stephanie Tapp, DPT
• Lore J Tarantino
• Rita Taylor, LCSW
• Tendercare Pediatrics
• Manoj M. Thakker, M.D.
• The Alcove Center for Grieving Children and Families, Inc
• The Arc of Atlantic County, Inc.
• The Moore Center, LLC
• The Urgent Care Group, PA

• Nephrology Physician in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.