Thomas a. Kedersha, MD, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MA37819 Issued in NJ

Legal business name

THOMAS A. KEDERSHA, MD, PA

Practice address

25 Mule Rd
Suite B2
Toms River, NJ 08755-5035

Phone

(732) 349-5453

Fax

(732) 681-3426

NPI assigned

Nov 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Thomas A Kedersha, MDNPI 1609957976

Title

Owner

Phone

(732) 681-0805

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Andrew Kedersha, M.D.

  • Surgery Physician
  • Toms River, NJ
  • NPI 1609957976
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1811298235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 W HURLEY POND RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199606",
            "telephone_number": "732-681-0805",
            "fax_number": "732-681-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MULE RD",
            "address_2": "SUITE B2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555035",
            "telephone_number": "732-349-5453",
            "fax_number": "732-681-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A. KEDERSHA, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "KEDERSHA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-681-0805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA37819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.