Individual provider Active NPI

Radhika S Remadevi, M.D.

  • Internal Medicine Physician
  • West Caldwell, NJ
National Provider Identifier
1174720304
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08661900 Issued in NJ
Practice address
1129 Bloomfield Ave
Suite 209
West Caldwell, NJ 07006-7127
Phone
(973) 500-2686
Fax
(973) 500-2686
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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 25MA08661900 NJ Primary

Addresses

Primary practice location

1129 Bloomfield Ave
Suite 209
West Caldwell, NJ 07006-7127

Mailing address

1129 Bloomfield Ave
Suite 209
West Caldwell, NJ 07006-7127
Phone (973) 500-2686

Other identifiers 1

IdentifierTypeStateIssuer
3798359000OtherNJAMERIHEALTH

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
I20100909000959 NJ Practitioner - Internal Medicine 8325163629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Partners LLCGroup PAC ID 2860665809, 74 clinicians

Practice addresses (Care Compare)

475 S St
Morristown, NJ 07960-6459
Phone (973) 971-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08661900NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Primary Care Partners, LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Primary Care Partners LLC Past Accepting new patients

Locations

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

1129 Bloomfield Ave
Ste 209
West Caldwell, NJ 07006
Phone (973) 500-2686

Organizations & group practices 3

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1174720304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 BLOOMFIELD AVE",
            "address_2": "SUITE 209",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067127",
            "telephone_number": "973-500-2686",
            "fax_number": "973-500-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 BLOOMFIELD AVE",
            "address_2": "SUITE 209",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067127",
            "telephone_number": "973-500-2686",
            "fax_number": "973-500-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMADEVI",
        "first_name": "RADHIKA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08661900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "3798359000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

Verify at the official NPI Registry.