Individual provider Active NPI

Arnold Derman, MD

  • Diagnostic Radiology Physician
  • East Brunswick, NJ
National Provider Identifier
1275515504
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA02194200 Issued in NJ
Practice address
579A Cranbury Rd
University Radiology Group PC
East Brunswick, NJ 08816-5426
Phone
(732) 390-0040
Fax
(732) 390-1856
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA02194200 NJ Primary

Addresses

Primary practice location

579A Cranbury Rd
University Radiology Group PC
East Brunswick, NJ 08816-5426

Mailing address

579A Cranbury Rd
University Radiology Group PC
East Brunswick, NJ 08816-5426
Phone (732) 390-0040

Other identifiers 2

IdentifierTypeStateIssuer
1411802MedicaidNJ
02197079MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1275515504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579A CRANBURY RD",
            "address_2": "UNIVERSITY RADIOLOGY GROUP PC",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165426",
            "telephone_number": "732-390-0040",
            "fax_number": "732-390-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579A CRANBURY RD",
            "address_2": "UNIVERSITY RADIOLOGY GROUP PC",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165426",
            "telephone_number": "732-390-0040",
            "fax_number": "732-390-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMAN",
        "first_name": "ARNOLD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA02194200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1411802",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02197079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.