Individual provider Active NPI

Hasmukh Sutaria, M.D

  • Neurology Physician
  • Irvington, NJ
National Provider Identifier
1366408056
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MA047626 Issued in NJ
Practice address
40, Union Ave
Suite 206
Irvington, NJ 07111
Phone
(973) 373-1196
Fax
(973) 373-1197
NPI assigned
Apr 22, 2006
Last updated
Apr 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 47626 NJ
Neurology Physician 2084N0400X MA047626 NJ Primary

Addresses

Primary practice location

40, Union Ave
Suite 206
Irvington, NJ 07111

Mailing address

40, Union Ave
Suite 206
Irvington, NJ 07111
Phone (973) 373-1196

Other identifiers 1

IdentifierTypeStateIssuer
5467004MedicaidNJ

Other names 1

  • Hasmukh Sutaria Professional name

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
I20040804001081 NJ Practitioner - Neurology 3678544434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Central Ave
East Orange, NJ 07018-2819
Phone (908) 769-4735

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47626NJMDNeurology Physician
MA047626NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edison Neurology LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

Interoperability endpoints

  • Direct secure messaging: hsutaria260241@epicdirect.rwjbh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1366408056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40, UNION AVE",
            "address_2": "SUITE 206",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "07111",
            "telephone_number": "973-373-1196",
            "fax_number": "973-373-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40, UNION AVE",
            "address_2": "SUITE 206",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "07111",
            "telephone_number": "973-373-1196",
            "fax_number": "973-373-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTARIA",
        "first_name": "HASMUKH",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "47626",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA047626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5467004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HASMUKH",
            "last_name": "SUTARIA",
            "credential": "MD PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.