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

Kevin Suttles

Individual provider Family Nurse Practitioner · NPI 1164143400

Kevin Suttles is a Nurse Practitioner in Passaic, New Jersey. Qualified in 2014, 12 years ago. Practices with Shah Anuj MD PC, a 29-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
12
Licensed in
NJ
In the registry since
2022

Practice location Address checks out

293 Passaic St
Passaic, NJ 07055-5803
Phone: (973) 916-0002
Fax: (973) 371-2543
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ01343800 (NJ)

Record details

NPI number1164143400
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 6, 2022
Last updated in NPPESSeptember 6, 2022
Certification dateSeptember 6, 2022
Mailing address293 Passaic St, Passaic, NJ 07055-5803

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Shah Anuj Md Pc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Passaic