Sudha R Kolli, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

MA69513 Issued in NJ

Practice address

262 Livingston Ave
New Brunswick, NJ 08901-3058

Phone

(732) 249-2044

Fax

(732) 790-2626

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Robert Wood Johnson Physician Enterprise

  • Family Medicine Physician
  • Somerset, NJ
  • NPI 1245587922

  Internal Medicine

  Medicare reassignment NPD
• Advanced Neurology Center LLC

  • Neurology Physician
  • Bridgewater, NJ
  • NPI 1760490148
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1174623508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 LIVINGSTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013058",
            "telephone_number": "732-249-2044",
            "fax_number": "732-790-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 LIVINGSTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013058",
            "telephone_number": "732-249-2044",
            "fax_number": "732-790-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLI",
        "first_name": "SUDHA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MA69513",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06951300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8181705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Knypinski, M.D.
• Kevin Ko, M.D.
• Eileen Kodack, DO
• Kristina Leigh Kokinda, DNP, CPNP AC/PC
• Jerzy Kolaczynski
• Gayathri Kollipara, DO
• Liliana Kolvites, ACNPC-AG
• Sarah Lyon Komline, MD
• Alexandra Kondratyeva, D.O,
• Soula G. Koniaris, MD

• Geriatric Medicine (Internal Medicine) Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.