Gautam C Surana, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA03494800 Issued in NJ

Practice address

520 Westfield Ave
Suite 305
Elizabeth, NJ 07208-1658

Phone

(908) 451-3511

NPI assigned

Sep 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 1

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

Specialty

Internal Medicine

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027
• Plaza Healthcare & Rehabilitation Center Nursing home, Elizabeth, NJ, CCN 315483
• Elizabeth Nursing and Rehab Center Nursing home, Elizabeth, NJ, CCN 315106

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Tidal Emergency Physicians LLC

  • Emergency Medicine Physician
  • Neptune, NJ
  • NPI 1649222407
  NPD (past)
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1770583999
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bracha Inc

  • Skilled Nursing Facility
  • Elizabeth, NJ
  • NPI 1942210026

  Nursing home

  Care Compare affiliation
• Plaza Health Care & Rehab. Cent.

  • Skilled Nursing Facility
  • Elizabeth, NJ
  • NPI 1790815447

  Nursing home

  Care Compare affiliation
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1134129802
  Care Compare affiliation
• Trinitas Regional Medical Center

  • Specialist
  • Elizabeth, NJ
  • NPI 1487697785

  Hospital

  Care Compare affiliation
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1770583999
  Care Compare affiliation
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1790785913
  Care Compare affiliation

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1437144391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WESTFIELD AVE",
            "address_2": "SUITE 305",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081658",
            "telephone_number": "908-351-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WESTFIELD AVE",
            "address_2": "SUITE 305",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081658",
            "telephone_number": "908-451-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURANA",
        "first_name": "GAUTAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA03494800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03494800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1535200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Strength Behavioral Services LLC
• Raghunandan Sundaram, M.D
• Super Medical Care Invalid Coach
• Superior Pharmacy LLC
• Ali R Surahio, M.D.
• Surgi Scripts Inc.
• Sushrut Healthcare, LLC
• Syed Ali Jaffry LLC
• Abdul Rehman Shah Syed
• Synergy Homecare of Elizabeth

• Internal Medicine Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.

Verify at the official NPI Registry.