NPIMap

Individual provider Active NPI

Purnima Vallabhaneni, MD

  • Internal Medicine Physician
  • Kendall Park, NJ
National Provider Identifier
1316945645
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07524200 Issued in NJ
Practice address
3084 State Route 27
Suite 1
Kendall Park, NJ 08824-1657
Phone
(732) 821-0873
Fax
(732) 297-7356
NPI assigned
Jul 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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 25MA07524200 NJ Primary

Addresses

Primary practice location

3084 State Route 27
Suite 1
Kendall Park, NJ 08824-1657

Mailing address

32 N Main St
Marlboro, NJ 07746-1429
Phone (732) 462-4100

Other identifiers 1

IdentifierTypeStateIssuer
9113703MedicaidNJ

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
I20100312000757 NJ Practitioner - Internal Medicine 3375678592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

111 James St
Edison, NJ 08820-3967
Phone (732) 452-9700

Hospital & facility affiliations

  • Hackensack Meridian JFK at Home Home health agency, Iselin, NJ, CCN 317059
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07524200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Urgent Care Plus PC Internal Medicine CurrentSince Feb 21, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Meridian Medical Group - Specialty Care, PC Internal Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

111 James St
Edison, NJ 08820
Phone (732) 452-9700

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3084 State Route 27
Ste 1
Kendall Park, NJ 08824
Phone (732) 821-0873

32 N Main St
Marlboro, NJ 07746
Phone (732) 462-4100

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

Interoperability endpoints

  • Direct secure messaging: purnima.vallabhaneni@maom.ehi.direct-ci.com
  • Direct secure messaging: purnima.vallabhaneni@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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.

Hospital & facility affiliations 7

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1316945645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461429",
            "telephone_number": "732-462-4100",
            "fax_number": "732-462-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3084 STATE ROUTE 27",
            "address_2": "SUITE 1",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241657",
            "telephone_number": "732-821-0873",
            "fax_number": "732-297-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLABHANENI",
        "first_name": "PURNIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07524200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9113703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendall Park, NJ

Sources for this page

Verify at the official NPI Registry.