Individual provider Active NPI

Yasunori Nagahama, MD

  • Neurological Surgery Physician
  • Somerset, NJ
National Provider Identifier
1033476569
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25MA11101500 Issued in NJ
Practice address
379 Campus Dr FL 4
Somerset, NJ 08873-1161
Phone
(732) 937-8939
NPI assigned
Apr 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X DR.0063720 CO
Neurological Surgery Physician 207T00000X MD-45124 IA
Neurological Surgery Physician 207T00000X 25MA11101500 NJ Primary
Neurological Surgery Physician 207T00000X R-9419 IA

Addresses

Primary practice location

379 Campus Dr FL 4
Somerset, NJ 08873-1161

Mailing address

379 Campus Dr FL 4
Somerset, NJ 08873-1161
Phone (732) 937-8939

Other identifiers 1

IdentifierTypeStateIssuer
791563MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012001945 NJ Practitioner - Neurosurgery 3072753201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-RWJ Neurosurgery FacultyGroup PAC ID 4587613443, 189 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

125 Paterson St
New Brunswick, NJ 08901-1962

210 Somerset St
New Brunswick, NJ 08901-1942
Phone (732) 235-8845

Rutgers Health-RWJ Neurosurgery
Suite 2200
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0063720COMDNeurological Surgery Physician
MD-45124IAMDNeurological Surgery Physician
R-9419IAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Sep 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Sep 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Current Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Past Accepting new patients

Locations

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

10 Plum St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-5530

210 Somerset St
New Brunswick, NJ 08901
Phone (201) 668-0427

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Interoperability endpoints

  • Direct secure messaging: ynagahama74904@epicdirect.rwjbh.org

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1335052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1033476569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 CAMPUS DR FL 4",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731161",
            "telephone_number": "732-937-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 CAMPUS DR FL 4",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731161",
            "telephone_number": "732-937-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGAHAMA",
        "first_name": "YASUNORI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-22",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "DR.0063720",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IA",
            "license": "MD-45124",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA11101500",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IA",
            "license": "R-9419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791563",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.