NPIMap

Individual provider Active NPI

Kundana Thimmanagari

  • Nephrology Physician
  • West Orange, NJ
National Provider Identifier
1306498167
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA11899700 Issued in NJ
Practice address
111 Northfield Ave
West Orange, NJ 07052-4795
Phone
(973) 325-2103
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA11899700 NJ Primary

Addresses

Primary practice location

111 Northfield Ave
West Orange, NJ 07052-4795

Mailing address

111 Northfield Ave
West Orange, NJ 07052-4795
Phone (973) 325-2103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806000250 NJ Practitioner - Nephrology 7214474469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nephrology Group PAGroup PAC ID 9133220825, 6 clinicians

Practice addresses (Care Compare)

111 Northfield Ave
Suite 311
West Orange, NJ 07052-4703
Phone (973) 325-2103

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Nephrology Group PA Nephrology CurrentSince Jul 1, 2024 Accepting new patients
3 Dimension Diagnostic Solutions PastSince Jul 1, 2024 Accepting new patients

Locations

111 Northfield Ave
West Orange, NJ 07052
Phone (201) 731-5006

111 Northfield Ave
Ste 311
West Orange, NJ 07052
Phone (201) 325-2103

Interoperability endpoints

  • Direct secure messaging: kundana.thimmanagari.1@9736.direct.athenahealth.com

Organizations & group practices 2

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 11

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1306498167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524795",
            "telephone_number": "973-325-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524795",
            "telephone_number": "973-325-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIMMANAGARI",
        "first_name": "KUNDANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA11899700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.