Pradosh Varghese

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00459800 Issued in NJ

Practice address

124 Washington Ave
Nutley, NJ 07110-3502

Phone

(973) 695-0885

Fax

(973) 771-3575

NPI assigned

Dec 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Jefferson Medical College of Thomas Jefferson University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SKR Medical AdvisorsGroup PAC ID 7315185816, 18 clinicians

The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• SKR Medical Advisors

  • Urgent Care Clinic/Center
  • Lyndhurst, NJ
  • NPI 1184971558
  Medicare reassignment Care Compare group
• The Radiology Group of New Jersey, LLC

  dba The Medical Group of New Jersey

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment Care Compare group
• DRX Paramus, LLC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  Medicare reassignment
• CMG Medical Group I LLC

  • Family Medicine Physician
  • Manalapan, NJ
  • NPI 1942778014
  NPD (past)
• Premier Care Associates of West Hudson

  • Internal Medicine Physician
  • Kearny, NJ
  • NPI 1821048570
  NPD (past)

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1063927812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 TWINBORO LN",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211245",
            "telephone_number": "551-497-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WASHINGTON AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103502",
            "telephone_number": "973-695-0885",
            "fax_number": "973-771-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "PRADOSH",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-01",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00459800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Unger, LCSW
• Universal Progressive Therapy, Inc.
• Susan Valenza, DISPENSING OPTICIAN
• Judyth Valera, PA
• Jessica Varghese
• Fernando Vazquez, MSW, LSW
• Edward J Vecchione, DO
• Melissa Stephanie Velasquez, PA
• Marion Lyle Venadas
• Allan Harold Verter, DC

• Medical Physician Assistant in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.