MEDICARE: DR. KIRA FELDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	MA070970	NJ
2	208000000X	Pediatrics Physician	MA070970	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23864	OTHER	NJ	AETNA/USHC HMO PROVIDER #
2	P2068029	OTHER	NJ	OXFORD PROVIDER ID #
3	5845148005	OTHER	NH	CIGNA PROVIDER ID #
4	2010619	OTHER	NJ	UNITED HEALTH CARE PROV #
5	60011030	OTHER	NJ	HORIZON NJ HEALTH PROV. #
6	202119279100	OTHER	NJ	QUALCARE PROVIDER ID #
7	89319	OTHER	NH	AMERIGROUP PROVIDER ID #
8	K5402	OTHER	NJ	HORIZON BC/BS PROVIDER #
9	2K5970	OTHER	NJ	HEALTHNET PROVIDER ID #
10	7755130	OTHER	NJ	AETNA/USHC PPO PROVIDER #
11	2354758001	OTHER	NJ	AMERIHEALTH PROVIDER ID #
12	8334200	OTHER	NJ	UNISYS NUMBER

General Provider Information

NPI Number	:	1629071014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRA FELDMAN MD

Provider Business Mailing Address
First Line	:	160 PENNSYLVANIA AVE
Second Line	:
City	:	BARNEGAT
State	:	NJ
Zip	:	08005-2061
Country	:	US
Telephone Number	:	609-607-0210
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 S MAIN ST
Second Line	:	SUITE 2
City	:	BARNEGAT
State	:	NJ
Zip	:	08005-2301
Country	:	US
Telephone Number	:	609-607-1010
Fax Number	:	609-601-9992

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/13/2021

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