Individual provider Active NPI

Srinivas S Vasireddi, M.D.

  • Gastroenterology Physician
  • Metuchen, NJ
National Provider Identifier
1417986167
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA06689300 Issued in NJ
Practice address
205 Bridge St
Metuchen, NJ 08840-2290
Phone
(732) 888-4800
Fax
(732) 444-3611
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA06689300 NJ Primary

Addresses

Primary practice location

205 Bridge St
Metuchen, NJ 08840-2290

Mailing address

205 Bridge St
BLDG D
Metuchen, NJ 08840-2290
Phone (732) 200-3535

Other identifiers 1

IdentifierTypeStateIssuer
7482507MedicaidNJ

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
I20060331000010 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 8325056559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Digestive Center, IncGroup PAC ID 9436167665, 2 clinicians

Practice addresses (Care Compare)

205 Bridge St
Metuchen, NJ 08840-2290
Phone (732) 888-4800

Merit-based Incentive Payment System (MIPS)

Final score
24.07 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy115
Upper gastrointestinal (GI) endoscopy for acid reflux81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Digestive Center, Inc Gastroenterology CurrentSince Aug 11, 2005 Accepting new patients

Locations

719 N Beers St
Ste 1F
Holmdel, NJ 07733
Phone (732) 200-3535

205 Bridge St
Bldg D
Metuchen, NJ 08840
Phone (201) 952-6520

205 Bridge St
Metuchen, NJ 08840
Phone (718) 795-7586

21 Jefferson Plz
Princeton, NJ 08540
Phone (201) 952-6520

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1417986167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BRIDGE ST",
            "address_2": "BLDG D",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402290",
            "telephone_number": "732-200-3535",
            "fax_number": "732-444-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BRIDGE ST",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402290",
            "telephone_number": "732-888-4800",
            "fax_number": "732-444-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASIREDDI",
        "first_name": "SRINIVAS",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA06689300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7482507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

Verify at the official NPI Registry.