KIDNEY CARE PA
NPI 1871918615
Internal Medicine - Nephrology in Maplewood, NJ
About Kidney Care Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIDNEY CARE PA (NPI 1871918615) is a healthcare organization registered as a nephrology in Maplewood, New Jersey and active in the NPI registry since March 2014. The organization lists Simon V Segun, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kidney Care Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kidney Care PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kidney Care PA's NPI number?
The NPI number for Kidney Care PA is 1871918615. It was assigned to this organization in the NPPES registry on March 4, 2014.
Where is Kidney Care PA located?
Kidney Care PA is located at 2130 Millburn Ave Suite C3, Maplewood, NJ 07040. The listed phone number is (973) 996-2727.
What is Kidney Care PA's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Kidney Care PA enrolled in Medicare?
Yes. Kidney Care PA is registered in the Medicare PECOS enrollment system.
When is Kidney Care PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Kidney Care PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Kidney Care PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Kidney Care PA accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Kidney Care PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kidney Care PA was last updated on April 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kidney Care Pa · NPI 1871918615
Nephrology organization in Maplewood, New Jersey. Organization record, active in the CMS NPPES registry since March 4, 2014.
## Identity
- **NPI:** 1871918615 (Entity type: Organization)
- **Enumerated:** March 4, 2014
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Simon Segun, MD
## Practice location
- **Address:** 2130 MILLBURN AVE, SUITE C3, Maplewood, NJ 07040-3725
- **Phone:** (973) 996-2727 · **Fax:** (973) 763-2558
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 16, 2015
- **Other identifiers:** Other 1194956490 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1871918615) · Data from the CMS NPPES public registry.