Peter A Keklak, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00051000 Issued in NJ

Practice address

3205 Fire Rd
Egg Harbor TWP, NJ 08234-5884

Phone

(029) 407-1220

Fax

(609) 407-0220

NPI assigned

Sep 16, 2006

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

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

Merit-based Incentive Payment System (MIPS)

Final score

91.83 of 100Reported as group

Quality

88.78

Promoting interoperability

99

Improvement activities

40

Cost

74.17

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment
• CMC Department of Medicine

  • Internal Medicine Physician
  • Camden, NJ
  • NPI 1104945005
  NPD
• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD
• Professional Service Fund of Deborah Heart & Lung Center

  • Specialist
  • Browns Mills, NJ
  • NPI 1407803596
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1760588669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 FIRE RD",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082345884",
            "telephone_number": "029-407-1220",
            "fax_number": "609-407-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEKLAK",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00051000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Medical Associates,PA
• Michael Jackson
• James E Rockwelll
• Jenna Ann Kane
• Stephen Moon Kang, D.M.D.
• Kids Care Pediatrics, PA
• Gregory W Kirwan, DO
• Rumyana Kudeva, LCSW
• William Lau
• Laychock Callahan LLC

• Physician Assistant in Egg Harbor TWP, NJ
• Providers in Egg Harbor TWP, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2023; 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.
• 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.