NPIMap

Individual provider Active NPI

Kathirgamathas Kurunathapillai, M.D.

  • Internal Medicine Physician
  • North Haledon, NJ
National Provider Identifier
1730112012
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08812800 Issued in NJ
Practice address
886 Belmont Ave Unit C2
North Haledon, NJ 07508-2573
Phone
(973) 333-5857
Fax
(201) 465-3225
NPI assigned
Jul 9, 2006
Last updated
May 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08812800 NJ Primary

Addresses

Primary practice location

886 Belmont Ave Unit C2
North Haledon, NJ 07508-2573

Mailing address

PO Box 425
Mahwah, NJ 07430-0425
Phone (845) 901-7487

Other identifiers 2

IdentifierTypeStateIssuer
0235024MedicaidNJ
02878673MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070802000266 NY Practitioner - Internal Medicine 4880666981 Reassigns benefits to 1 organization
I20130201000188 NJ Practitioner - Internal Medicine 4880666981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 Woodhaven Dr
Edison, NJ 08817-3766
Phone (845) 901-7487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08812800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thaas Medical, LLC Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients

Locations

886 Belmont Ave
Unit C2
North Haledon, NJ 07508
Phone (845) 901-7487

242 N Main St
New City, NY 10956
Phone (845) 354-9200

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

476 Christian Herald Rd
Vly Cottage, NY 10989
Phone (845) 268-6861

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1730112012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074300425",
            "telephone_number": "845-901-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 BELMONT AVE UNIT C2",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082573",
            "telephone_number": "973-333-5857",
            "fax_number": "201-465-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUNATHAPILLAI",
        "first_name": "KATHIRGAMATHAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08812800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235024",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02878673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haledon, NJ

Sources for this page

Verify at the official NPI Registry.