Individual provider Active NPI

Susanne Opeyemi Ajao, MD

  • Infectious Disease Physician
  • Newark, NJ
National Provider Identifier
1205312337
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25MA11741300 Issued in NJ
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(973) 877-5000
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 25MA11741300 NJ Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

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
I20231122000353 NJ Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345698858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rutgers Health-RWJ Scleroderma ProgramGroup PAC ID 5193764991, 390 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

1 Robert Wood Johnson Place
Robert Wood Johnson Hospital
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

125 Paterson St
New Brunswick, NJ 08901-1962

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Oct 9, 2023 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Oct 9, 2023 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Past Accepting new patients

Locations

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 4200
New Brunswick, NJ 08901
Phone (732) 235-6600

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1205312337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-828-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAO",
        "first_name": "SUSANNE",
        "middle_name": "OPEYEMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA11741300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.