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

Kishore Kuppasani

Individual provider Medical Physician Assistant · NPI 1659568954

Kishore Kuppasani is a Physician Assistant in Newark, New Jersey. Qualified in 2007, 19 years ago. Practices with Practice Associates Medical Group, a 1,403-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
19
Licensed in
NJ
In the registry since
2007
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Practice location Address checks out

185 S Orange Ave Uh H-346
Newark, NJ 07103-2757
Phone: (973) 972-5283
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 25MP00184900 (NJ)

Record details

NPI number1659568954
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 1, 2007
Last updated in NPPESOctober 1, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Practice Associates Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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