Active NPI
Neethu Gopisetti, M.D.
- Nephrology Physician
- Brick, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 25MA11355500
- Practice address
- 210 Jack Martin Blvd Ste D1
Brick, NJ 08724-3063 - Phone
- (732) 458-5854
- Fax
- (732) 458-8012
- NPI assigned
- Apr 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MT212548 | PA | |
| Nephrology Physician | 207RN0300X | 25MA11355500 | NJ | Primary |
Addresses
Primary practice location
210 Jack Martin Blvd Ste D1
Brick, NJ 08724-3063
Mailing address
210 Jack Martin Blvd Ste D1
Brick, NJ 08724-3063
Phone (732) 458-5854
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
508 Lakehurst Rd
Suite 3a
Toms River, NJ 08755-8000
Phone (732) 341-4600
Hospital & facility affiliations
- Ocean Medical Center
- Community Medical Center
- Jersey Shore University Medical Center
- Monmouth Medical Center-Southern Campus
- JFK University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT212548 | PA | MD | Internal Medicine Physician |
| 25MA11355500 | NJ | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Kidney Care LLC | Internal Medicine | Current | Accepting new patients |
Locations
210 Jack Martin Blvd
Ste D1
Brick, NJ 08724
Phone (732) 341-4600
83 Hanover Rd
Ste 290
Florham Park, NJ 07932
Phone (973) 259-0278
1301 Route 72 W
Ste 206
Manahawkin, NJ 08050
Phone (609) 978-9940
444 Neptune Blvd
Unit 5
Neptune, NJ 07753
Phone (732) 458-5854
508 Lakehurst Rd
Ste 3A
Toms River, NJ 08755
Phone (732) 341-4600
201 Laurel Oak Rd
#B
Voorhees, NJ 08043
Phone (856) 566-5478
Interoperability endpoints
- ngopisetti42481@direct.acumenmd.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Brick, NJ
- NPI 1023889565
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Toms River, NJ
- NPI 1013010917
-
- General Acute Care Hospital
- Edison, NJ
- NPI 1144894577
-
- General Acute Care Hospital
- Brick, NJ
- NPI 1477065126
-
- General Acute Care Hospital
- Neptune, NJ
- NPI 1790297547
-
- General Acute Care Hospital
- Lakewood, NJ
- NPI 1225133473
-
- General Acute Care Hospital
- Long Branch, NJ
- NPI 1609983790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1366977324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 JACK MARTIN BLVD STE D1",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243063",
"telephone_number": "732-458-5854",
"fax_number": "732-458-8012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 JACK MARTIN BLVD STE D1",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243063",
"telephone_number": "732-458-5854",
"fax_number": "732-458-8012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOPISETTI",
"first_name": "NEETHU",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-27",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MT212548",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NJ",
"license": "25MA11355500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.