Active NPI
Edward Michael Killilea, M.D.
- Cardiovascular Disease Physician
- Kearny, NJ
National Provider Identifier
1982654406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MA 27589
- Practice address
- 111 Grand PL
Kearny, NJ 07032-1846 - Phone
- (201) 998-2142
- Fax
- (201) 997-7650
- NPI assigned
- May 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MA 27589 | NJ | Primary |
Addresses
Primary practice location
111 Grand PL
Kearny, NJ 07032-1846
Mailing address
111 Grand PL
Kearny, NJ 07032-1846
Phone (201) 998-2142
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050913000036 | NJ | Practitioner - Cardiovascular Disease (Cardiology) | 9234162165 | Practice locations: Kearny, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Georgetown University School of Medicine, 1972
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
111 Grand PL
Kearny, NJ 07032-1846
Phone (201) 998-2142
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 27589 | NJ | MD | Cardiovascular Disease Physician |
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Belleville, NJ
- NPI 1902901333
-
- General Acute Care Hospital
- Newark, NJ
- NPI 1568825545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982654406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 GRAND PL",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321846",
"telephone_number": "201-998-2142",
"fax_number": "201-997-7650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 GRAND PL",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321846",
"telephone_number": "201-998-2142",
"fax_number": "201-997-7650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLILEA",
"first_name": "EDWARD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "MA 27589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kearny, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.