Individual provider Active NPI

Solomon S Kuchipudi, M.D.

  • Internal Medicine Physician
  • Somerset, NJ
National Provider Identifier
1073544284
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA74312 Issued in NJ
Practice address
636 Easton Ave
Somerset, NJ 08873-1975
Phone
(732) 220-8811
Fax
(732) 220-1300
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA74312 NJ Primary

Addresses

Primary practice location

636 Easton Ave
Somerset, NJ 08873-1975

Mailing address

636 Easton Ave
Somerset, NJ 08873-1975
Phone (732) 220-8811

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
I20041207000020 NJ Practitioner - Internal Medicine 8921064494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

636 Easton Ave
Somerset, NJ 08873-1975

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA74312NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Solomon Kuchipudi MD LLC Internal Medicine CurrentSince Jul 1, 2002 Accepting new patients

Locations

636 Easton Ave
Ste 1
Somerset, NJ 08873
Phone (732) 220-8811

636 Easton Ave
Somerset, NJ 08873
Phone (732) 220-8811

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEJAED/Endpoint/JEJAED

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1073544284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 EASTON AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731975",
            "telephone_number": "732-220-8811",
            "fax_number": "732-220-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 EASTON AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731975",
            "telephone_number": "732-220-8811",
            "fax_number": "732-220-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHIPUDI",
        "first_name": "SOLOMON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA74312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.