Individual provider Active NPI

Pratibha Avinash Kulkarni, M.D.

  • Internal Medicine Physician
  • Millburn, NJ
National Provider Identifier
1306867478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA 41977 Issued in NJ
Practice address
116 Millburn Ave
Suite # 108
Millburn, NJ 07041-1943
Phone
(973) 564-5227
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA 41977 NJ Primary

Addresses

Primary practice location

116 Millburn Ave
Suite # 108
Millburn, NJ 07041-1943

Mailing address

297 Walnut St
Livingston, NJ 07039-5009
Phone (973) 564-5227

Other identifiers 1

IdentifierTypeStateIssuer
1883402MedicaidNJ

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
I20070803000020 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4385735463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA 41977NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Dec 1, 2020 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

1 Harmon Plz
Fl 10
Secaucus, NJ 07094
Phone (201) 636-7233

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

Interoperability endpoints

  • Direct secure messaging: pkulkarni77222@direct.optum.com

Organizations & group practices 3

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306867478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 WALNUT ST",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395009",
            "telephone_number": "973-564-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MILLBURN AVE",
            "address_2": "SUITE # 108",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411943",
            "telephone_number": "973-564-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULKARNI",
        "first_name": "PRATIBHA",
        "middle_name": "AVINASH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA 41977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.