Robert Russell Sudol, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

48441 Issued in NJ

Practice address

408 E Jimmie Leeds Rd
Galloway, NJ 08205-9706

Phone

(609) 652-6947

Fax

(609) 748-9075

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• New Jersey Medical and Health Associates,LLC

  dba CarePoint Health Medical Group

  • Internal Medicine Physician
  • Hoboken, NJ
  • NPI 1558673582
  Medicare reassignment NPD
• Robert R R Sudol MD LLC

  • Specialist
  • Galloway, NJ
  • NPI 1538407655
  NPD (past) Authorized official

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1154424182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059706",
            "telephone_number": "609-652-6956",
            "fax_number": "609-748-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059706",
            "telephone_number": "609-652-6947",
            "fax_number": "609-748-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDOL",
        "first_name": "ROBERT",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "48441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celena Storck-Martinez, LCSW
• Stouffers Nursing and Staffing LLC
• Strive Physical Therapy Specialists LLC
• Kelly Stueber, PT
• Nancy E Sudol, ANPC
• Sure Hearing Services, LLC
• Alexander Swankoski, LAC
• Sean Anthony Swisher, PHARMD.
• Evdoxia P Szczotka
• Lauren Elise Szymkowski, OTR/L

• Internal Medicine Physician in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.