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SUBURBAN NEPHROLOGY GROUP PA
NPI 1972614022
Specialist in Wayne, NJ

Active since August 31, 2006CLIA 31D0939795 · Microscopy
510 HAMBURG TPKE, SUITE 108, WAYNE, NJ 07470(973) 389-1119(973) 389-1145 Get Directions Write a Review

NPPES record last updated: December 30, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Suburban Nephrology Group Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUBURBAN NEPHROLOGY GROUP PA (NPI 1972614022) is a healthcare organization registered as a specialist in Wayne, New Jersey and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through February 1, 2028 and lists Sam Rae, Physician, as its authorized official.

NPPES Registry Identity

NPI1972614022
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSUBURBAN NEPHROLOGY GROUP PA
Location Address510 HAMBURG TPKE, SUITE 108Wayne, NJ 07470-2025
Mailing Address510 Hamburg Tpke, Suite 108Wayne, NJ 07470-2025 · (973) 389-1119 · Fax (973) 389-1145
Phone(973) 389-1119
Fax(973) 389-1145
Organization SubpartNo
Authorized OfficialSam RaePhysician · (973) 389-1119
Enumeration DateAugust 31, 2006
Last NPPES UpdateDecember 30, 2019
✔ NPI 1972614022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
510 HAMBURG TPKE, Wayne, NJ 07470
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Suburban Nephrology Group Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Suburban Nephrology Group PA, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Ignazio Fazio, MD
Nephrology
NPI 1972500528
342 HAMBURG TPKE STE 201
Wayne, NJ 07470
(973) 389-1119
✔ PECOS✔ Accepts Medicare0.4 mi
Monalisa Joseph, MD
Nephrology
NPI 1578849345
342 HAMBURG TPKE SUITE# 201
Wayne, NJ 07470
(973) 389-1119
✔ PECOS✔ Accepts Medicare0.4 mi
Sam Rae, MD
Nephrology
NPI 1649277294
342 HAMBURG TPKE STE 201
Wayne, NJ 07470
(973) 389-1119
✔ PECOS✔ Accepts Medicare0.4 mi
Kevin Vitting, MD
Nephrology
NPI 1598762148
342 HAMBURG TPKE STE 201
Wayne, NJ 07470
(973) 389-1119
✔ PECOS✔ Accepts Medicare0.4 mi
Eugene Zeltser, MD
Nephrology
NPI 1215948617
342 HAMBURG TPKE SUITE 201
Wayne, NJ 07470
(973) 389-1119
✔ PECOS✔ Accepts Medicare0.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 31D0939795

Suburban Nephrology Group PA · Wayne, NJ
Active · expires Feb 1, 2028
CLIA Number31D0939795
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorKevin E. Vitting
Laboratory Phone(973) 398-1119
Laboratory LocationSuburban Nephrology Group PA342 Hamburg Turnpike Suite 201, Wayne, NJ 07470
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Suburban Nephrology Group PA's NPI number?

The NPI number for Suburban Nephrology Group PA is 1972614022. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Suburban Nephrology Group PA located?

Suburban Nephrology Group PA is located at 510 Hamburg Tpke Suite 108, Wayne, NJ 07470. The listed phone number is (973) 389-1119.

What is Suburban Nephrology Group PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Suburban Nephrology Group PA enrolled in Medicare?

Yes. Suburban Nephrology Group PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Suburban Nephrology Group PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nephrology, reassign their Medicare billing to Suburban Nephrology Group 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. Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Suburban Nephrology Group PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 31D0939795) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Suburban Nephrology Group PA accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Suburban Nephrology Group 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 Suburban Nephrology Group PA was last updated on December 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.