Individual provider Active NPI

William Richard Chenitz, MD, FACP

  • Nephrology Physician
  • Newark, NJ
National Provider Identifier
1972531457
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA021777 Issued in NJ
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(973) 624-4908
Fax
(973) 877-5595
NPI assigned
Jun 30, 2006
Last updated
Apr 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA021777 NJ Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

111 Central Ave
Newark, NJ 07102
Phone (973) 624-4908

Other identifiers 1

IdentifierTypeStateIssuer
1161709MedicaidNJ

Other names 1

  • William Richard Chenitz Professional name

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
I20050805000037 NJ Practitioner - Nephrology 3971404955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA021777NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Kidney Group PA Nephrology Past Accepting new patients
Richmar Medical Associates 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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1972531457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-624-4908",
            "fax_number": "973-877-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-624-4908",
            "fax_number": "973-877-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENITZ",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD, FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA021777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1161709",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "CHENITZ",
            "middle_name": "RICHARD",
            "credential": "MD, FACP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.