KAMERON TAVAKOLIAN (MD) – Internal Medicine Physician, NPI 1104406313

KAMERON TAVAKOLIAN (MD) is a healthcare provider. based in Middletown, New Jersey. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 25MA12251800 (NJ). The NPI Number for KAMERON TAVAKOLIAN (MD) is 1104406313

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
KAMERON TAVAKOLIAN (MD)
NPI
1104406313
Phone
(240) 506-1005
Address
1006 AROSE LN
Enumeration Date
12 April 2021
Last Update Date
7 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7327755500
Graduation Year
2021 (5 years ago)
PAC ID
1759828387
Group Practice PAC ID
1355561663
Professional Enrollment ID
I20240731004894
Address ID
NJ077534859NE1945X33XX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

6,910 INTERNAL MEDICINE in NJ

Provider Addresses for KAMERON TAVAKOLIAN (MD)

  • 1006 AROSE LN

    MIDDLETOWN, NJ 077481942

    Phone: (240) 506-1005

    Type: Mailing

  • 10204 SUNDANCE CT

    POTOMAC, MD 208544052

    Phone: (240) 506-1005

    Type: Mailing

  • 1945 STATE ROUTE 33

    NEPTUNE, NJ 077534859

    Phone: (732) 775-5500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $65.

Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.

Last reported payment date: 2024-03-21 • Largest payer in this snapshot: ABBVIE INC. ($51).

Total Amount

$65

General + Research + Ownership

Payments

4

Total payment records

General Amount

$65

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-31

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240731004894IInternal MedicineNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07748)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355561663View full group profile
NameSpecialtyState
Internal MedicineNJ
Nurse PractitionerNJ
Internal MedicineNJ
Family PracticeVT
Internal MedicineNJ
Internal MedicineNJ
-NJ
-NJ
Internal MedicineNJ
Internal MedicineNY

Reviews

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Frequently asked questions

What federal number belongs to KAMERON TAVAKOLIAN (MD)?
The federal identifier for KAMERON TAVAKOLIAN (MD) is NPI 1104406313.
Is KAMERON TAVAKOLIAN (MD)'s NPI currently valid?
The extract we use shows KAMERON TAVAKOLIAN (MD) as active.
What kind of provider is KAMERON TAVAKOLIAN (MD)?
The page reflects Internal Medicine Physician for KAMERON TAVAKOLIAN (MD). Clinical services aligned with this taxonomy classification.
What location shows for KAMERON TAVAKOLIAN (MD)?
We surface Middletown, New Jersey for KAMERON TAVAKOLIAN (MD) based on available NPPES addresses.
Is KAMERON TAVAKOLIAN (MD) a real provider?
This page reflects official NPPES data for NPI 1104406313. Always confirm identity and privileges with the practice and licensing boards.

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