| Northeast Kidney Care Llc | |
|
210 Jack Martin Blvd Ste D1 Brick NJ 08724-7771 | |
| (732) 458-5854 | |
| Not Available |
| Full Name | Northeast Kidney Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 210 Jack Martin Blvd Ste D1, Brick, New Jersey |
| Authorized Official Name and Position | Ankit Shah (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7324585854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Kidney Care Llc 210 Jack Martin Blvd Ste D1 Brick NJ 08724-7771 Ph: (732) 458-5854 | Northeast Kidney Care Llc 210 Jack Martin Blvd Ste D1 Brick NJ 08724-7771 Ph: (732) 458-5854 |
| NPI Number | 1023889565 |
|---|---|
| Provider Enumeration Date | 01/12/2024 |
| Last Update Date | 11/18/2024 |
| Medicare PECOS PAC ID | 8921445032 |
|---|---|
| Medicare Enrollment ID | O20240326000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023889565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| Provider Name | Anthony Brown |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780631150 PECOS PAC ID: 8729077672 Enrollment ID: I20040507000194 |
| Provider Name | Daniel Joseph Brouder |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659313963 PECOS PAC ID: 5890779482 Enrollment ID: I20040614000063 |
| Provider Name | Priyesh T Thakkar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1689683815 PECOS PAC ID: 0547231235 Enrollment ID: I20040805000107 |
| Provider Name | Joseph P Zingrone |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1619923109 PECOS PAC ID: 6608849344 Enrollment ID: I20040819000540 |
| Provider Name | Therese K Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598712960 PECOS PAC ID: 8527032184 Enrollment ID: I20040820000677 |
| Provider Name | Carmen Canals-navas |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1144277518 PECOS PAC ID: 6002889797 Enrollment ID: I20040820000734 |
| Provider Name | Evelynn F Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073652830 PECOS PAC ID: 0749255438 Enrollment ID: I20040826001150 |
| Provider Name | Neil Lyman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1619078367 PECOS PAC ID: 9537054390 Enrollment ID: I20040827000309 |
| Provider Name | Angelo Markatos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447279245 PECOS PAC ID: 0345218509 Enrollment ID: I20040924000378 |
| Provider Name | Paul J Svigals |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265452684 PECOS PAC ID: 2062460033 Enrollment ID: I20050107000392 |
| Provider Name | Richard Daniels |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1417905043 PECOS PAC ID: 3577476837 Enrollment ID: I20050722000017 |
| Provider Name | Gerardo Varallo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821044496 PECOS PAC ID: 0143232850 Enrollment ID: I20060621000241 |
| Provider Name | Melind R Pandya |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396853602 PECOS PAC ID: 6305843384 Enrollment ID: I20061106000075 |
| Provider Name | Sacha Balmir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255438131 PECOS PAC ID: 2264431451 Enrollment ID: I20061218000139 |
| Provider Name | Joseph Schirripa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1609804384 PECOS PAC ID: 6204937915 Enrollment ID: I20070725000409 |
| Provider Name | Jay Shastri |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477758720 PECOS PAC ID: 5496856924 Enrollment ID: I20070727000024 |
| Provider Name | Kezia J Alberto |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073721809 PECOS PAC ID: 1951494954 Enrollment ID: I20070907000115 |
| Provider Name | Mark B Schuster |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1851595565 PECOS PAC ID: 5597835413 Enrollment ID: I20080604000522 |
| Provider Name | Charles O Nnewihe |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760419097 PECOS PAC ID: 1557424645 Enrollment ID: I20090115000628 |
| Provider Name | Jeffrey W Goodman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1316977416 PECOS PAC ID: 0648266403 Enrollment ID: I20090713000624 |
| Provider Name | Ariel Meyer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083887129 PECOS PAC ID: 2668528787 Enrollment ID: I20090915000334 |
| Provider Name | Jose I Iglesias |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1467498402 PECOS PAC ID: 9335280197 Enrollment ID: I20091231000171 |
| Provider Name | Nadeem Z. Haider |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508801390 PECOS PAC ID: 8022159409 Enrollment ID: I20100107000295 |
| Provider Name | Jin S Park |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902842057 PECOS PAC ID: 5597749408 Enrollment ID: I20100201000604 |
| Provider Name | Winicjusz Palecki |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942240429 PECOS PAC ID: 8426136623 Enrollment ID: I20100202000031 |
| Provider Name | Jo E. Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548297237 PECOS PAC ID: 6103961172 Enrollment ID: I20100302000239 |
| Provider Name | Jay Irving Stack |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245325026 PECOS PAC ID: 5890869895 Enrollment ID: I20100826001010 |
| Provider Name | Michael D Yoslov |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780653956 PECOS PAC ID: 9133270606 Enrollment ID: I20100925000085 |
| Provider Name | Robert David Zenenberg |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245331834 PECOS PAC ID: 9234149014 Enrollment ID: I20101022000805 |
| Provider Name | Gopika Banker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649460189 PECOS PAC ID: 4587852496 Enrollment ID: I20101220000482 |
| Provider Name | Geralyn M Gedaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013221050 PECOS PAC ID: 0143419374 Enrollment ID: I20110104000800 |
| Provider Name | Nitesh M Patel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1639360910 PECOS PAC ID: 4183802226 Enrollment ID: I20110621000108 |
| Provider Name | Robert J Mathews |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902060221 PECOS PAC ID: 9739253147 Enrollment ID: I20110928000578 |
| Provider Name | Raymond Schreyer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518976745 PECOS PAC ID: 5991738973 Enrollment ID: I20111122000758 |
| Provider Name | Nitin Behl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235423807 PECOS PAC ID: 9234396847 Enrollment ID: I20120209000710 |
| Provider Name | Ankit Prafulbhai Shah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972741957 PECOS PAC ID: 1052551751 Enrollment ID: I20130701000058 |
| Provider Name | Seema Karanjgaokar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1841521598 PECOS PAC ID: 0143407411 Enrollment ID: I20130725000811 |
| Provider Name | Jessica Bonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588053326 PECOS PAC ID: 4587982137 Enrollment ID: I20150413000634 |
| Provider Name | Mrugesh C Panchani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013213206 PECOS PAC ID: 3476867086 Enrollment ID: I20150727001826 |
| Provider Name | Lacey A Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710362520 PECOS PAC ID: 5890004782 Enrollment ID: I20151015000777 |
| Provider Name | Eliza Mae M Tangonan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477964971 PECOS PAC ID: 2163725151 Enrollment ID: I20160408001265 |
| Provider Name | Karandeep S Jagpal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457632572 PECOS PAC ID: 8224317334 Enrollment ID: I20161114000734 |
| Provider Name | Yiling Yao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992246839 PECOS PAC ID: 9739459868 Enrollment ID: I20170724001730 |
| Provider Name | Janet I Ojeabulu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013250646 PECOS PAC ID: 4688939580 Enrollment ID: I20180524000681 |
| Provider Name | Riffat Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447517321 PECOS PAC ID: 6608164017 Enrollment ID: I20180829004723 |
| Provider Name | Mary Jane Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508357104 PECOS PAC ID: 5991055576 Enrollment ID: I20180830003453 |
| Provider Name | Laura M. Perrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720561715 PECOS PAC ID: 7517208580 Enrollment ID: I20190402000009 |
| Provider Name | Dirksen Taguiam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639640790 PECOS PAC ID: 8921349853 Enrollment ID: I20190403000100 |
| Provider Name | Sneha Shrestha |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295146058 PECOS PAC ID: 4880927052 Enrollment ID: I20190604001288 |
| Provider Name | Gary Romaka |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1316280852 PECOS PAC ID: 6002197712 Enrollment ID: I20190604002882 |
| Provider Name | Azza Abdel Hak |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508135906 PECOS PAC ID: 2567602600 Enrollment ID: I20190822000176 |
| Provider Name | Hillary Jo Driscoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801415112 PECOS PAC ID: 3779902465 Enrollment ID: I20200930000133 |
| Provider Name | Michael Dennis Appleton |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811346927 PECOS PAC ID: 4981013810 Enrollment ID: I20210506000244 |
| Provider Name | Matthew A Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952061616 PECOS PAC ID: 4587058102 Enrollment ID: I20220224002521 |
| Provider Name | Neethu Gopisetti |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1366977324 PECOS PAC ID: 4789954611 Enrollment ID: I20220602001018 |
| Provider Name | Olusola R Akintola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316688468 PECOS PAC ID: 0749669455 Enrollment ID: I20220625000356 |
| Provider Name | Ashton Roxie Paulus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972244333 PECOS PAC ID: 4385029438 Enrollment ID: I20220910000107 |
| Provider Name | Nicole E Nardiello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720702871 PECOS PAC ID: 4880063767 Enrollment ID: I20221215002641 |
| Provider Name | Amar M Bhagat |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1881126514 PECOS PAC ID: 6204208440 Enrollment ID: I20230216000050 |
| Provider Name | Brittany Nicole Brothers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881350791 PECOS PAC ID: 8224404298 Enrollment ID: I20230227000043 |
| Provider Name | Amy Yongqing Mu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790563955 PECOS PAC ID: 5698122851 Enrollment ID: I20231109000109 |
| Provider Name | Kelly Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558144030 PECOS PAC ID: 5496107914 Enrollment ID: I20240122000098 |
| Provider Name | Nicole Elston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487412706 PECOS PAC ID: 8921447764 Enrollment ID: I20240412003201 |
| Provider Name | Eric Fels |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821089590 PECOS PAC ID: 8921178740 Enrollment ID: I20240415003548 |
| Provider Name | Thi T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831958511 PECOS PAC ID: 0840732038 Enrollment ID: I20240603003456 |
| Provider Name | Yashika Jani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164254645 PECOS PAC ID: 7214469634 Enrollment ID: I20241010000810 |
| Provider Name | Stephanie R Neville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245045590 PECOS PAC ID: 5890217590 Enrollment ID: I20250324000353 |
| Provider Name | Miguel Angel Perez Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851165187 PECOS PAC ID: 5496279622 Enrollment ID: I20250409003378 |
Qkhanmd Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Jack Martin Blvd, Brick, NJ 08724 Phone: 848-242-6303 | |
Jersey Shore Rejuvination Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Brick Blvd Ste 124, Brick, NJ 08723 Phone: 732-262-2809 Fax: 732-262-0400 | |
Michael L Sher Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 74 Brick Blvd, Suite #115, Brick, NJ 08723 Phone: 732-920-8001 Fax: 732-920-8004 | |
Cedarbridge Medical Associates, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 985 Cedarbridge Ave, Brick, NJ 08723 Phone: 732-477-5600 Fax: 732-477-1899 | |
Rosa Ital, Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1140 Burnt Tavern Rd Ste 2a, Brick, NJ 08724 Phone: 732-202-7307 Fax: 732-349-5229 | |
Meridian Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Jack Martin Blvd, Brick, NJ 08724 Phone: 732-836-4664 Fax: 732-836-4665 |