Individual provider Active NPI

Suganya Kathiravan, M.D

  • Neonatal-Perinatal Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1124257787
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
45055 Issued in AZ
Practice address
1 Robert Wood Johnson PL
Bristol-Myers Squibb Childrens Hospital at Rwjuh
New Brunswick, NJ 08901-1928
Phone
(732) 235-5709
NPI assigned
Jul 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 45055 AZ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
Bristol-Myers Squibb Childrens Hospital at Rwjuh
New Brunswick, NJ 08901-1928

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-1813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220609001896 AZ Practitioner - Pediatric Medicine 8628242575 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Honorhealth Past Accepting new patients
Obstetrix Medical Group of Phoenix PC Maternal & Fetal Medicine Past Accepting new patients
Honorhealth Past Accepting new patients
Dignity Community Care Past Accepting new patients
Phoenix Children'S Hospital Past Accepting new patients

Locations

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

3420 S Mercy Rd
Ste 121
Gilbert, AZ 85297
Phone (602) 933-2263

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

1111 E McDowell Rd
Fl 3
Phoenix, AZ 85006

Interoperability endpoints

  • Direct secure messaging: skathiravan241258@direct.valleywisehealth.org

Organizations & group practices 7

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": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1124257787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "address_2": "BRISTOL-MYERS SQUIBB CHILDRENS HOSPITAL AT RWJUH",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHIRAVAN",
        "first_name": "SUGANYA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-03",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "45055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.