Individual provider Active NPI

Eden Kasaev, PHARMD

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1851805725
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
061472 Issued in NY
Practice address
4166 White Plains Rd
Bronx, NY 10466-3020
Phone
(718) 881-5800
Fax
(718) 881-5803
NPI assigned
Nov 29, 2017
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 061472 NY Primary

Addresses

Primary practice location

4166 White Plains Rd
Bronx, NY 10466-3020

Mailing address

8054 Kent St
Jamaica, NY 11432-1545
Phone (347) 681-5191

Other practice location 1

1106 Avenue K Fl 1
Brooklyn, NY 11230-4145
Phone (718) 253-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
061472NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shalom's Diabetes Health and Wellness Center Past Accepting new patients
Shaloms Pharmacy Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1851805725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8054 KENT ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321545",
            "telephone_number": "347-681-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4166 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104663020",
            "telephone_number": "718-881-5800",
            "fax_number": "718-881-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 Avenue K Fl 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112304145",
            "country_code": "US",
            "telephone_number": "718-253-4900",
            "fax_number": "718-253-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASAEV",
        "first_name": "EDEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-29",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "061472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.