Individual provider Active NPI

Mikhail Kagan, M.D.

  • Anesthesiology Physician
  • Summit, NJ
National Provider Identifier
1871936237
Registry record updated Feb 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA10286300 Issued in NJ
Practice address
33 Overlook Rd Ste 311
Summit, NJ 07901
Phone
(718) 309-5855
NPI assigned
Apr 16, 2013
Last updated
Feb 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA10286300 NJ Primary

Addresses

Primary practice location

33 Overlook Rd Ste 311
Summit, NJ 07901

Mailing address

33 Overlook Rd Ste 311
Summit, NJ 07901-3563
Phone (908) 598-1500

Other practice location 1

100 Nicols Road
Department of Anesthesiology Stony Brook Medicine
Stony Brook, NY 11794-8480
Phone (631) 444-2975

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181211001135 NJ Practitioner - Anesthesiology 4880938364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergen Anesthesia Group, P.C.Group PAC ID 6608861794, 61 clinicians

Practice addresses (Care Compare)

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 847-9403

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.05 of 100Reported as group
Quality
46.59
Improvement activities
40
Cost
64.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10286300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen Anesthesia Group, P.C. CurrentSince Jul 1, 2022 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Summit Anesthesia Associates PA Anesthesiology PastSince Feb 9, 2020 Accepting new patients

Locations

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

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.

Hospital & facility affiliations 1

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580515200000",
    "number": "1871936237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 311",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013563",
            "telephone_number": "908-598-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 311",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "718-309-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Nicols Road",
            "address_2": "Department of Anesthesiology Stony Brook Medicine",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948480",
            "country_code": "US",
            "telephone_number": "631-444-2975",
            "fax_number": "631-444-2907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2020-02-01",
        "certification_date": "2020-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10286300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.