NPIMap

Individual provider Active NPI

Sukrut Dwivedi, D.O.

  • Infectious Disease Physician
  • Oakhurst, NJ
National Provider Identifier
1003082660
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25MB08394700 Issued in NJ
Practice address
1912 State Route 35
Suite 101
Oakhurst, NJ 07755-2715
Phone
(732) 222-4762
Fax
(732) 222-4764
NPI assigned
May 5, 2008
Last updated
May 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 25MB08394700 NJ Primary

Addresses

Primary practice location

1912 State Route 35
Suite 101
Oakhurst, NJ 07755-2715

Mailing address

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091028000109 NJ Practitioner - Infectious Disease 6901943703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
New York College of Osteo Medicine of New York Institute of Technology, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Id Care LLCGroup PAC ID 7719959998, 119 clinicians

Practice addresses (Care Compare)

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.12
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Id Care LLC Infectious Disease CurrentSince Aug 1, 2011 Accepting new patients
Monmouth Infectious Disease Associates, LLC Past Accepting new patients

Locations

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

1912 State Route 35
Ste 101
Oakhurst, NJ 07755
Phone (732) 222-4762

211 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 222-4762

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGIACA/Endpoint/AGIACA
  • Direct secure messaging: sukrut.dwivedi@idca.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1003082660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD",
            "address_2": "SUITE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221",
            "fax_number": "908-281-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 STATE ROUTE 35",
            "address_2": "SUITE 101",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077552715",
            "telephone_number": "732-222-4762",
            "fax_number": "732-222-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIVEDI",
        "first_name": "SUKRUT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MB08394700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, NJ

Sources for this page

Verify at the official NPI Registry.