John Ivan Sutter, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA03777100 Issued in NJ

Practice address

925 Clifton Ave
Suite 102
Clifton, NJ 07013-2724

Phone

(973) 778-2083

Fax

(973) 778-1584

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• John Ivan Sutter, MD, PA

  • Pediatrics Physician
  • Clifton, NJ
  • NPI 1326279795
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1407848575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHITTENDEN RD STE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070134203",
            "telephone_number": "201-456-4251",
            "fax_number": "973-778-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CLIFTON AVE",
            "address_2": "SUITE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132724",
            "telephone_number": "973-778-2083",
            "fax_number": "973-778-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "JOHN",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA037771",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03777100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO",
            "identifier": "223674880",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.