Individual provider Active NPI

Thressiamma M Cholankeril, MD

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1083644322
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA 43326 Issued in NJ
Practice address
100 Grove St
Elizabeth, NJ 07202-1111
Phone
(908) 352-1738
Fax
(908) 820-0966
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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 MA 43326 NJ Primary

Addresses

Primary practice location

100 Grove St
Elizabeth, NJ 07202-1111

Mailing address

100 Grove St
Elizabeth, NJ 07202-1111
Phone (908) 352-1738

Other identifiers 1

IdentifierTypeStateIssuer
2021005MedicaidNJ

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
I20040405000081 NJ Practitioner - Internal Medicine 5991798274 Reassigns benefits to 1 organization
Practice locations: Elizabeth, NJ; Rahway, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cholankeril Medical Associates MD LLCGroup PAC ID 7416922562, 3 clinicians

Practice addresses (Care Compare)

100 Grove St
Elizabeth, NJ 07202-1111
Phone (908) 352-1735

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA 43326NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cholankeril Medical Associates MD LLC CurrentSince Feb 17, 2009 Accepting new patients
Trinitas Regional Medical Center Past Accepting new patients

Locations

100 Grove St
Elizabeth, NJ 07202
Phone (908) 352-1735

1507 Saint Georges Ave
Rahway, NJ 07065
Phone (732) 382-2177

1600 Saint Georges Ave
Ste 106
Rahway, NJ 07065
Phone (732) 382-2177

Interoperability endpoints

  • Direct secure messaging: dr.thressiamma.cholankeril@direct.digidms.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1083644322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GROVE ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021111",
            "telephone_number": "908-352-1738",
            "fax_number": "908-820-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GROVE ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021111",
            "telephone_number": "908-352-1738",
            "fax_number": "908-820-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOLANKERIL",
        "first_name": "THRESSIAMMA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA 43326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.