Individual provider Active NPI

Swarna Priya Sivanesan, M.D.

  • Dermatology Physician
  • Freehold, NJ
National Provider Identifier
1104024165
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA08774100 Issued in NJ
Practice address
901 W Main St
Suite 201
Freehold, NJ 07728-2537
Phone
(732) 637-9982
Fax
(215) 383-0114
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA08774100 NJ Primary

Addresses

Primary practice location

901 W Main St
Suite 201
Freehold, NJ 07728-2537

Mailing address

901 W Main St
Suite 201
Freehold, NJ 07728-2537
Phone (732) 637-9982

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
I20110131000987 NJ Practitioner - Dermatology 1456530880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Morehouse School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology ClinicGroup PAC ID 4981830601, 5 clinicians

Practice addresses (Care Compare)

107 Monmouth Rd
Suite 203
West Long Branch, NJ 07764-1021
Phone (732) 222-2250

Merit-based Incentive Payment System (MIPS)

Final score
98.04 of 100Reported as individual
Quality
96.08
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Removal of skin lesions1521
Removal of skin cancer1-10
Removal or shaving of skin growth14
Skin biopsy341

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Partners Dermatology Current Accepting new patients
The Dermatology Clinic CurrentSince Oct 15, 2013 Accepting new patients

Locations

901 W Main St
Ste 201
Freehold, NJ 07728
Phone (732) 222-2250

107 Monmouth Rd
Ste 203
West Long Branch, NJ 07764
Phone (732) 222-2250

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1104024165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-637-9982",
            "fax_number": "215-383-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-637-9982",
            "fax_number": "215-383-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVANESAN",
        "first_name": "SWARNA",
        "middle_name": "PRIYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA08774100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.