Individual provider Active NPI

Padmaja Annamaneni, MD

  • Psychiatry Physician
  • Perth Amboy, NJ
National Provider Identifier
1205914520
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA07314500 Issued in NJ
Practice address
570 Lee Street
Raritan Bay Mental Health Center
Perth Amboy, NJ 08861-3053
Phone
(732) 442-1666
Fax
(732) 442-9512
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA07314500 NJ Primary

Addresses

Primary practice location

570 Lee Street
Raritan Bay Mental Health Center
Perth Amboy, NJ 08861-3053

Mailing address

570 Lee Street
Raritan Bay Mental Health Center
Perth Amboy, NJ 08861-3053
Phone (732) 442-1666

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
I20040510001094 NJ Practitioner - Psychiatry 4284623778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of MiddlesexGroup PAC ID 0547165904, 16 clinicians

Practice addresses (Care Compare)

570 Lee St
Perth Amboy, NJ 08861-3053
Phone (732) 442-1666

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Middlesex CurrentSince Jun 9, 2011 Accepting new patients
County of Middlesex CurrentSince Jun 9, 2011 Accepting new patients
Corby Pharma Inc PastSince Jul 13, 2009 Accepting new patients
Lumit RX Inc PastSince Apr 23, 2008 Accepting new patients
Neurorehab Institute LLC Past Accepting new patients
Upper Manhattan Pharma Inc PastSince Feb 18, 2016 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Psychiatry Past Accepting new patients
Jolin RX Inc. PastSince Mar 5, 2008 Accepting new patients
Gerald Tramontano Senior Care Residential and Community Program Past Accepting new patients
Rutgers Health - Behavioral Health Psychiatry Past Accepting new patients
Rutgers Health - Behavioral Health Psychiatry Past Accepting new patients
115 Irving Ave Pharmacy Inc PastSince Jan 23, 2017 Accepting new patients

Locations

570 Lee St
Perth Amboy, NJ 08861
Phone (732) 442-1666

Organizations & group practices 12

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1205914520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LEE STREET",
            "address_2": "RARITAN BAY MENTAL HEALTH CENTER",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613053",
            "telephone_number": "732-442-1666",
            "fax_number": "732-442-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LEE STREET",
            "address_2": "RARITAN BAY MENTAL HEALTH CENTER",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613053",
            "telephone_number": "732-442-1666",
            "fax_number": "732-442-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAMANENI",
        "first_name": "PADMAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07314500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.