Individual provider Active NPI

Robert A Sirota, MD

  • Nephrology Physician
  • Hainesport, NJ
National Provider Identifier
1174547079
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA09461300 Issued in NJ
Practice address
1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone
(856) 222-1975
Fax
(856) 222-0721
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD022066E PA
Nephrology Physician 207RN0300X 25MA09461300 NJ Primary

Addresses

Primary practice location

1261 Route 38
Suite a
Hainesport, NJ 08036-2702

Mailing address

1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone (856) 222-1975

Other identifiers 11

IdentifierTypeStateIssuer
02334MD022066EOtherPAHEALTH PARTNERS
0490482MedicaidNJ
096081OtherPAHIGHMARK BLUE SHIELD
0284284OtherPACIGNA
096083OtherPAHIGHMARK
0069877002OtherPAAMERI CHOICE
0048674000OtherPAIBC
390003999OtherPARAILROAD MEDICARE
1030006OtherPAKEYSTONE MERCY
4089601OtherPAAETNA
0006987700003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1174547079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROTA",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD022066E",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA09461300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "02334MD022066E",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490482",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "096081",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0284284",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "096083",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERI CHOICE",
            "identifier": "0069877002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0048674000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390003999",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1030006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4089601",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006987700003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.