NPIMap

Individual provider Active NPI

Raghuveer Annam, M.D.

  • Internal Medicine Physician
  • Phillipsburg, NJ
National Provider Identifier
1386735850
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05360800 Issued in NJ
Practice address
461 Corliss Ave
Phillipsburg, NJ 08865-1501
Phone
(908) 859-5872
Fax
(908) 859-1747
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 25MA05360800 NJ Primary

Addresses

Primary practice location

461 Corliss Ave
Phillipsburg, NJ 08865-1501

Mailing address

461 Corliss Ave
Phillipsburg, NJ 08865-1501
Phone (908) 859-5872

Other identifiers 2

IdentifierTypeStateIssuer
223435441OtherNJHORIZON BLUE CROSS BLUE S
0471500MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050926000183 NJ Practitioner - Internal Medicine 6800820218 Reassigns benefits to 1 organization
I20120424000180 PA Practitioner - Internal Medicine 6800820218

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

279 State Route 31 S
Washington, NJ 07882-4098
Phone (484) 503-7546

755 Memorial Pkwy
Phillipsburg, NJ 08865-2774

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05360800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Sep 1, 2022 Accepting new patients
St. Luke's Warren Physician Group, PC Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

461 Corliss Ave
Phillipsburg, NJ 08865
Phone (908) 454-9725

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

Interoperability endpoints

  • Direct secure messaging: raghuveer.annam2@slpg.direct-sluhn.org

Organizations & group practices 5

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 12

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386735850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 CORLISS AVE",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651501",
            "telephone_number": "908-859-5872",
            "fax_number": "908-859-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 CORLISS AVE",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651501",
            "telephone_number": "908-859-5872",
            "fax_number": "908-859-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAM",
        "first_name": "RAGHUVEER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05360800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE CROSS BLUE S",
            "identifier": "223435441",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0471500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.