Individual provider Active NPI

Rekha Agrawal, MD

  • Internal Medicine Physician
  • Warren, NJ
National Provider Identifier
1073638797
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MAO6103700 Issued in NJ
Practice address
6 Orchard Way
Warren, NJ 07059-5056
Phone
(908) 418-0409
Fax
(908) 363-1013
NPI assigned
Mar 20, 2007
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 25MAO6103700 NJ Primary

Addresses

Primary practice location

6 Orchard Way
Warren, NJ 07059-5056

Mailing address

6 Orchard Way
Warren, NJ 07059-5056
Phone (908) 222-9004

Other identifiers 1

IdentifierTypeStateIssuer
6344604MedicaidNJ

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
I20050926000605 NJ Practitioner - Internal Medicine 0648264929 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MAO6103700NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Medical LLC Internal Medicine CurrentSince Sep 27, 2002 Accepting new patients

Locations

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

5 Mountain Blvd
Ste 3
Warren, NJ 07059
Phone (908) 755-5335

Interoperability endpoints

  • Direct secure messaging: rekhaagrawal@amsmedical.ssdirect.aprima.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1073638797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ORCHARD WAY",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595056",
            "telephone_number": "908-222-9004",
            "fax_number": "908-363-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ORCHARD WAY",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595056",
            "telephone_number": "908-418-0409",
            "fax_number": "908-363-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRAWAL",
        "first_name": "REKHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MAO6103700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6344604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

Verify at the official NPI Registry.