Kathleen M. Cerkvenik, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA042021 Issued in NJ

Practice address

541 Cedar Hill Ave
Wyckoff, NJ 07481-2150

Phone

(201) 652-0300

Fax

(201) 444-6209

NPI assigned

Mar 20, 2006

Last updated

Apr 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Bergen West Pediatric Center, PA

  • Pediatrics Physician
  • Wyckoff, NJ
  • NPI 1285693119
  Authorized official Same address or phone

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1740249671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 CEDAR HILL AVENUE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812150",
            "telephone_number": "201-445-4630",
            "fax_number": "201-444-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 CEDAR HILL AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812150",
            "telephone_number": "201-652-0300",
            "fax_number": "201-444-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERKVENIK",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA042021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald N Cauchard, OD
• Angela Cays, LPC
• Cedar Hill Obstetrical & Gynecological Assoc PA (Nicholas Asimakopulos MD)
• Cedar Hill Obstetrics & Gynecology Associates,PA
• Center for Remote Medical Management LLC
• Julie Yuet Nor Chan
• Dianne D Chase, COTA
• Cheryl Schrader, LLC
• Chiropractic Wellness Center of Wyckoff Inc
• Joseph Charles Christ

• Pediatrics Physician in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.