Individual provider Active NPI

Samir Rajan, M.D.

  • Internal Medicine Physician
  • Edison, NJ
National Provider Identifier
1174719124
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08304500 Issued in NJ
Practice address
2177 Oak Tree Rd
Edison, NJ 08820-1082
Phone
(908) 769-4735
NPI assigned
Sep 23, 2007
Last updated
May 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08304500 NJ Primary

Addresses

Primary practice location

2177 Oak Tree Rd
Edison, NJ 08820-1082

Mailing address

26 E Julius St
Iselin, NJ 08830-2604
Phone (908) 208-4306

Other identifiers 1

IdentifierTypeStateIssuer
0160202MedicaidNJ

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
I20080428000006 NJ Practitioner - Internal MedicinePractitioner - Nephrology 6901984244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Kidney Disease and Hypertension LLCGroup PAC ID 5496851925, 4 clinicians

Practice addresses (Care Compare)

2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082
Phone (908) 769-4735

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08304500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Kidney Disease & Hypertension LLC CurrentSince Jul 20, 2011 Accepting new patients
Associates in Kidney Disease & Hypertension, P.C. Past Accepting new patients

Locations

2177 Oak Tree Rd
Ste 204
Edison, NJ 08820
Phone (908) 686-9330

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1174719124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 E JULIUS ST",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302604",
            "telephone_number": "908-208-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-769-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAN",
        "first_name": "SAMIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-23",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08304500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.