Organization Active NPI

Associates in Kidney Disease & Hypertension LLC

  • Nephrology Physician
  • Edison, NJ
National Provider Identifier
1295894038
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA07583200 Issued in NJ
Legal business name
ASSOCIATES IN KIDNEY DISEASE & HYPERTENSION LLC
Practice address
2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082
Phone
(908) 769-4735
Fax
(908) 769-4736
NPI assigned
Dec 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Dr. Samir Sutaria, M.D.NPI 1083677579
Title
Physician
Phone
(908) 769-4735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 25MA07583200 NJ Primary

Addresses

Primary practice location

2177 Oak Tree Rd
Suite 204
Edison, NJ 08820-1082

Mailing address

17 Anna LN
Edison, NJ 08820-1503
Phone (908) 769-4735

Other identifiers 1

IdentifierTypeStateIssuer
0076538MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070501000018 NJ Part B Supplier - Clinic/Group Practice 5496851925 Receives reassigned benefits from 5 practitioners
Practice locations: Edison, NJ
O20170519002292 NJ DME Supplier - Physician - General Practice 5496851925 Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1295894038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ANNA LN",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201503",
            "telephone_number": "908-769-4735",
            "fax_number": "908-769-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD",
            "address_2": "SUITE 204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-769-4735",
            "fax_number": "908-769-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN KIDNEY DISEASE & HYPERTENSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "SUTARIA",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "908-769-4735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA07583200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076538",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.