Individual provider Active NPI

Sriranjani Ganesan

  • Occupational Therapist
  • Bound Brook, NJ
National Provider Identifier
1205368149
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00701000 Issued in NJ
Practice address
675 Tea St
Apt 3304
Bound Brook, NJ 08805-1189
Phone
(972) 697-1563
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00701000 NJ Primary

Addresses

Primary practice location

675 Tea St
Apt 3304
Bound Brook, NJ 08805-1189

Mailing address

675 Tea St
Apt 3304
Bound Brook, NJ 08805-1189
Phone (972) 697-1563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723003551 NJ Practitioner - Occupational Therapist in Private Practice 2163968488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgeway Care at Home LLCGroup PAC ID 6406198373, 39 clinicians

Practice addresses (Care Compare)

Bridgewater, NJ 08807
Phone (908) 722-7022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00701000NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeway Care at Home, LLC Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

270 State Route 28
Bridgewater, NJ 08807
Phone (908) 722-7022

Organizations & group practices 1

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1205368149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TEA ST",
            "address_2": "APT 3304",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051189",
            "telephone_number": "972-697-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 TEA ST",
            "address_2": "APT 3304",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051189",
            "telephone_number": "972-697-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESAN",
        "first_name": "SRIRANJANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00701000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bound Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.