Active NPI
Ajantha Rangasamy, M.D.
- Internal Medicine Physician
- Staten Island, NY
National Provider Identifier
1194882613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 241341
- Practice address
- 355 Bard Ave
Staten Island, NY 10310-1664 - Phone
- (718) 818-1234
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 241341 | NY | Primary |
Addresses
Primary practice location
355 Bard Ave
Staten Island, NY 10310-1664
Mailing address
222 Prospect Ave
FL 2
Bayonne, NJ 07002-4722
Phone (646) 251-5722
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100707000478 | NJ | Practitioner - Internal Medicine | 5496835241 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Garden State Healthcare Associates LLC
Practice addresses (Care Compare)
29 E 29TH St
Bayonne, NJ 07002-4654
308 Willow Ave
Hoboken, NJ 07030-3808
Hospital & facility affiliations
- Carepoint Health - Bayonne Medical Center
- Bayonne University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241341 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ijkg Opco LLC | Current | Accepting new patients | |
| Ijkg Opco LLC | Past | Accepting new patients | |
| Richmond University Medical Center | Past | Accepting new patients | |
| Richmond University Medical Center | Past | Accepting new patients |
Interoperability endpoints
- ajantha.rangasamy@direct.bayonnemedicalcenter.md
Organizations & group practices 5
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.
-
- Skilled Nursing Facility
- Bayonne, NJ
- NPI 1437356755
-
- Medicare Defined Swing Bed Hospital Unit
- Staten Island, NY
- NPI 1548489701
-
- Multi-Specialty Clinic/Center
- Staten Island, NY
- NPI 1811054042
-
- General Acute Care Hospital
- Bayonne, NJ
- NPI 1821101239
Hospital & facility affiliations 2
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": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194882613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 PROSPECT AVE",
"address_2": "FL 2",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070024722",
"telephone_number": "646-251-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "718-818-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANGASAMY",
"first_name": "AJANTHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "241341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.