NPIMap

Individual provider Active NPI

Kyrillos ABA Nob Rezkalla, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Neptune, NJ
National Provider Identifier
1912560558
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
25MA11507500 Issued in NJ
Practice address
1945 State Route 33
Neptune, NJ 07753-4859
Phone
(732) 775-5500
NPI assigned
Apr 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA11507500 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA11507500 NJ Primary
Internal Medicine Physician 207R00000X 25MA11507500 NJ

Addresses

Primary practice location

1945 State Route 33
Neptune, NJ 07753-4859

Mailing address

136 Jackson St
Matawan, NJ 07747-3119
Phone (718) 873-4539

Other practice location 1

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-6946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802000728 NJ Practitioner - Internal MedicinePractitioner - Nephrology 7416318837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plover Inpatient Services LLCGroup PAC ID 1355561663, 158 clinicians
Kidney Care CentersGroup PAC ID 6204279441, 23 clinicians
Shore Pulmonary, PAGroup PAC ID 3173593431, 18 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000

27 S Cooks Bridge Rd
Suite 2 11
Jackson, NJ 08527-2463
Phone (732) 460-1200

301 Bingham Ave
Suite B
Ocean, NJ 07712-4764
Phone (732) 775-9075

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11507500NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Centers Nephrology CurrentSince Jun 20, 2025 Accepting new patients
Shore Pulmonary, PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

1608 Route 88 W
Ste 117
Brick, NJ 08724
Phone (732) 775-9075

1 Bethany Rd
Ste 91
Hazlet, NJ 07730
Phone (732) 847-3662

27 S Cooks Bridge Rd
Ste 2-11
Jackson, NJ 08527
Phone (732) 575-1100

2640 Highway 70
Ste 6A
Manasquan, NJ 08736
Phone (732) 528-5900

1945 Corlies Ave
#33
Neptune City, NJ 07753
Phone (732) 776-4203

301 Bingham Ave
Ste B
Ocean, NJ 07712
Phone (732) 575-1100

301 Bingham Ave
Ste 1B
Ocean, NJ 07712
Phone (732) 775-9075

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

1031 McBride Ave
Ste D209
Woodland Park, NJ 07424
Phone (973) 222-8387

Interoperability endpoints

  • Direct secure messaging: krezkalla17586@prd.direct.tbh.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HJHEDD
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.351
  • Direct secure messaging: krezkalla47180@direct.davitaphysiciansolutions.com

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 8

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1912560558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JACKSON ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473119",
            "telephone_number": "718-873-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 STATE ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-775-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Dekalb Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112015425",
            "country_code": "US",
            "telephone_number": "718-250-6946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZKALLA",
        "first_name": "KYRILLOS",
        "middle_name": "ABA NOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA11507500",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA11507500",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11507500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.