MARK L KAVANAGH (NPI# 1558514380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558514380 |
| Entity Type | Individual |
| Full Name | MARK L KAVANAGH |
| Credential | MD |
| Practice Address |
61 Beaverbrook Rd Suite 201 Lincoln Park NJ 07035-1748 |
| Practice Telephone | 9736869292 |
| Practice Fax Number | 9736869294 |
| Mailing Telephone | 9736869292 |
| Mailing Fax Number | 9736869294 |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2014-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 25MA08991900 | NJ | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
0101245447 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1558514380 | 05 | |
| VA | BCBS | 1558514380 | 01 |
| Street Address |
61 BEAVERBROOK RD SUITE 201 |
| City | LINCOLN PARK |
| State | NJ |
| Zip Code | 07035-1748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437126091 | Advanced Physical Therapy and Wellness Center, LLC | Clinic/Center | 61 Beaverbrook Rd, Suite 103, Lincoln Park, NJ 07035-1748 | 2006-03-02 |
| 1578906004 | Sandra J Mainardi | Physical Therapy Assistant | 61 Beaverbrook Rd, Suite 103, Lincoln Park, NJ 07035-1748 | 2013-04-15 |
| 1104154434 | Julie Ann Kulinski | Physical Therapist | 61 Beaverbrook Rd, Suite 103, Lincoln Park, NJ 07035-1748 | 2009-11-24 |
| 1821235136 | Joel G. Fischgrund M.d.p.a. | Family Medicine | 61 Beaverbrook Rd, Suite 301, Lincoln Park, NJ 07035-1748 | 2009-01-08 |
| 1902064983 | Sue Ellen Rose | Nurse Practitioner | 61 Beaverbrook Rd, Lincoln Park, NJ 07035-1748 | 2008-05-27 |
| 1619155314 | Advanced Injury Care II, Inc. | Clinic/Center | 61 Beaverbrook Rd, Suite 103, Lincoln Park, NJ 07035-1748 | 2008-02-05 |
| 1962699835 | Advanced Surgical Solutions, LLC | Specialist | 61 Beaverbrook Rd, Suite 101, Lincoln Park, NJ 07035-1748 | 2007-09-25 |
| 1265463574 | Eddy N Fischgrund | Chiropractor | 61 Beaverbrook Rd, Suite 103, Lincoln Park, NJ 07035-1748 | 2006-07-05 |
| 1427097534 | Joel Gary Fischgrund | Family Medicine | 61 Beaverbrook Rd, Suite 301, Lincoln Park, NJ 07035-1748 | 2006-06-05 |
| 1598712556 | Orthopedic Surgery & Sports Medicine Center, LLC | Specialist | 61 Beaverbrook Rd, Ste 201, Lincoln Park, NJ 07035-1748 | 2006-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306333802 | Nancy Barrett | Massage Therapist | 63 Beaver Brook Road, Suite 105, Lincoln Park, NJ 07035 | 2018-04-19 |
| 1407182801 | Jody S Chimbel-berg | Occupational Therapist | 503 Pine Brook Rd., Lincoln Park, NJ 07035 | 2009-10-20 |
| 1588999486 | Jeffrey Michael Falduto | Dentist | 8 Chapel Hill Road, Lincoln Park, NJ 07035 | 2009-10-09 |
| 1467785519 | Richard Anthony Ashman | Physical Therapy Assistant | 503 Pine Brook Road, Lincoln Park, NJ 07035 | 2009-09-08 |
| 1679795835 | Anju Budhwani | Internal Medicine | 166 Main St Ste 1a, Lincoln Park, NJ 07035 | 2007-05-03 |
| 1740356575 | Anna Marie Kotsen | Marriage & Family Therapist | 59 Beaver Brook Rd, Suite 303d, Lincoln Park, NJ 07035 | 2006-11-24 |
| 1700992039 | Jeffrey M Falduto Dmd Dental Practice LLC | Dentist | 8 Chapel Hill Rd, Lincoln Park, NJ 07035 | 2006-08-21 |
| 1063877207 | Kenneth Fernandez | Occupational Therapy Assistant | 209 Comly Rd, M13, Lincoln Park, NJ 07035 | 2015-12-15 |
| 1316273717 | Beata Hertel-kiszkiel | Occupational Therapist | 503 Pine Brook Road, Lincoln Park, NJ 07035 | 2009-10-20 |
| 1750523726 | Walgreen Co | Pharmacy | 153 Main St, Lincoln Park, NJ 07035 | 2009-04-06 |
| Find all providers in zip 07035 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699787200 | Bahadur S Bohra | Orthopaedic Surgery | 1336 Southfield Rd, Lincoln Park, MI 48146-2319 | 2006-08-12 |
| 1386810711 | B.s. Bohra M.d. P.C. | Orthopaedic Surgery | 1336 Southfield Rd, Lincoln Park, MI 48146-2319 | 2008-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342507 | Virtua Medical Group, Pa | Orthopaedic Surgery | 1315 Route 9 S Ste 101, Cape May Court House, NJ 08210-2931 | 2020-10-01 |
| 1811501521 | Genfit Medical LLC | Orthopaedic Surgery | 143 E Ridgewood Ave Ste 765, Ridgewood, NJ 07450-3815 | 2020-09-01 |
| 1285257212 | Nexgen Wellness | Orthopaedic Surgery | 33 E Midland Ave Unit 1365, Paramus, NJ 07652-2916 | 2020-05-26 |
| 1558984955 | Orozco Orthopaedics LLC | Orthopaedic Surgery | 517 Route 72 W Ste K, Manahawkin, NJ 08050-2821 | 2020-05-20 |
| 1801417423 | Genfit Health | Orthopaedic Surgery | 143 E Ridgewood Ave Ste 784, Ridgewood, NJ 07450-3815 | 2020-05-05 |
| 1033730106 | Premier Orthopaedic & Sports Medicine Assoc of Southern Nj LLC | Orthopaedic Surgery | 698 Mullica Hill Rd Ste 150, Mullica Hill, NJ 08062-4454 | 2020-04-30 |
| 1750902862 | Premier Orthopaedic & Sports Medicine Assoc of Southern Nj LLC | Orthopaedic Surgery | 556 Egg Harbor Rd Ste A, Sewell, NJ 08080-2326 | 2020-04-29 |
| 1386271625 | South Shore Orthotics and Bracing | Orthopaedic Surgery | 649 Shore Rd Ste 0, Somers Point, NJ 08244-2449 | 2020-03-26 |
| 1528601796 | Casey Cresbaugh | Orthopaedic Surgery | 201 Nj-rt 17, Suite 1202, Rutherford, NJ 07070 | 2019-10-21 |
| 1881245561 | Multi-speciality Orthopedics LLC | Orthopaedic Surgery | 225 Millburn Ave Ste 104a, Millburn, NJ 07041-1712 | 2019-09-24 |
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| City | LINCOLN PARK |
| Zip Code | 07035 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.