Active NPI
Niranjan K Penupatruni, M.D.
- Surgery Physician
- Edison, NJ
National Provider Identifier
1053585588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25MA04541800
- Practice address
- 80 James St FL 4
Edison, NJ 08820-3938 - Phone
- (732) 632-1571
- Fax
- (732) 632-1644
- NPI assigned
- Apr 16, 2008
- Last updated
- Jan 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25MA04541800 | NJ | Primary |
Addresses
Primary practice location
80 James St FL 4
Edison, NJ 08820-3938
Mailing address
695 US Highway 46
Ste 400a
Fairfield, NJ 07004-1568
Phone (973) 826-8291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0024163 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital Group, Inc | Surgery | Past | Accepting new patients |
| Community Hospital Group, Inc | Past | Accepting new patients | |
| Bharati D Penupatruni MD LLC | Past | Accepting new patients |
Interoperability endpoints
- niranjan.penupatruni@direct.hackensackmeridian.org
Organizations & group practices 3
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.
-
- General Practice Physician
- Monmouth JCT, NJ
- NPI 1760928014
-
dba JFK MRMC Assistant Surgeons
- Specialist
- Edison, NJ
- NPI 1427278258
Surgery
-
dba JFK Cardiology
- Cardiovascular Disease Physician
- Edison, NJ
- NPI 1467670224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1053585588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 US HIGHWAY 46",
"address_2": "STE 400A",
"city": "FAIRFIELD",
"state": "NJ",
"postal_code": "070041568",
"telephone_number": "973-826-8291",
"fax_number": "888-972-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 JAMES ST FL 4",
"city": "EDISON",
"state": "NJ",
"postal_code": "088203938",
"telephone_number": "732-632-1571",
"fax_number": "732-632-1644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENUPATRUNI",
"first_name": "NIRANJAN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-16",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "25MA04541800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0024163",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.