NPIMap

Individual provider Active NPI

Samir Sutaria, MD

  • Nephrology Physician
  • Edison, NJ
National Provider Identifier
1083677579
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA07583200 Issued in NJ
Practice address
2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082
Phone
(908) 686-9330
Fax
(908) 769-4736
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA07583200 NJ Primary

Addresses

Primary practice location

2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082

Mailing address

2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082
Phone (908) 686-9330

Other identifiers 1

IdentifierTypeStateIssuer
0076538MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050913000159 NJ Practitioner - Nephrology 1658304506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Kidney Disease and Hypertension LLCGroup PAC ID 5496851925, 4 clinicians

Practice addresses (Care Compare)

2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082
Phone (908) 769-4735

Hospital & facility affiliations

  • DaVita Durham Corners Dialysis Dialysis facility, South Plainfield, NJ, CCN 312607
  • DaVita South Edison Dialysis facility, Edison, NJ, CCN 312714
  • DaVita Plainfield Dialysis Dialysis facility, Plainfield, NJ, CCN 312558
  • DaVita Edison Dialysis Dialysis facility, Edison, NJ, CCN 312559
  • DaVita Metuchen Dialysis facility, Metuchen, NJ, CCN 312654
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Kidney Disease & Hypertension LLC Nephrology CurrentSince Sep 26, 2006 Accepting new patients
Associates in Kidney Disease & Hypertension, P.C. Nephrology Past Accepting new patients

Locations

2177 Oak Tree Rd
Ste 204
Edison, NJ 08820
Phone (908) 686-9330

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1083677579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD",
            "address_2": "SUITE 204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-686-9330",
            "fax_number": "908-769-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD",
            "address_2": "SUITE 204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-686-9330",
            "fax_number": "908-769-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTARIA",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA07583200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076538",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.