Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin John

Individual provider Medical Physician Assistant · NPI 1063266138

Kevin John is a Physician Assistant in Dover, New Jersey. Qualified in 2024, 2 years ago. Practices with Ccmma Nj LLC, a 30-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

400 W Blackwell St
Dover, NJ 07801-2525
Phone: (201) 779-4473
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1063266138
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 15, 2024
Last updated in NPPESApril 15, 2024
Certification dateApril 15, 2024
Mailing address155 3rd St, Bergenfield, NJ 07621-1439

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ccmma Nj Llc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Dover