Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Kevin Shailesh Avichal, PA-C

Individual provider Physician Assistant · NPI 1174040539

Mr. Kevin Shailesh Avichal, PA-C is a Physician Assistant in Union, New Jersey. Qualified in 2017, 9 years ago. Practices with Summit Medical Group PA, a 1,205-clinician group and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
9
Licensed in
NJ, NY
In the registry since
2017
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2317 Center Island Route 22
Union, NJ 07083
Phone: (201) 354-1951
Fax: (201) 354-1952
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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 25MP00445700 (NJ)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00445700 (NJ)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 25MP00445700 (NJ)
Physician Assistant Taxonomy 363A00000X · Licence 021217 (NY)

Record details

NPI number1174040539
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 26, 2017
Last updated in NPPESMay 2, 2024
Certification dateApril 24, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Summit Medical Group Pa — 1205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Union