Individual provider Active NPI

Purna Bindu Nandigam, MD

  • Nephrology Physician
  • Wayne, NJ
National Provider Identifier
1457619421
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA09737700 Issued in NJ
Practice address
246 Hamburg Tpke
Suite #207
Wayne, NJ 07470-2156
Phone
(973) 653-3366
Fax
(973) 653-3365
NPI assigned
Apr 27, 2012
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA09737700 NJ
Nephrology Physician 207RN0300X 25MA09737700 NJ Primary

Addresses

Primary practice location

246 Hamburg Tpke
Suite #207
Wayne, NJ 07470-2156

Mailing address

246 Hamburg Tpke
Suite #207
Wayne, NJ 07470-2156
Phone (973) 653-3366

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
I20151007001470 NJ Practitioner - NephrologyPractitioner - Internal Medicine 0749598951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

200 Wyckoff Rd
Suite 3300
Eatontown, NJ 07724-1927
Phone (732) 571-0972

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09737700NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Healthcare, Inc. Internal Medicine CurrentSince Mar 19, 2018 Accepting new patients
Barnabas Health Medical Group PC Internal Medicine CurrentSince Dec 3, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Dec 3, 2023 Accepting new patients

Locations

200 Wyckoff Rd
Ste 3300
Eatontown, NJ 07724
Phone (732) 571-0672

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

377 Jersey Ave
Ste 280A
Jersey City, NJ 07302
Phone (201) 716-5850

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Ste 305
Livingston, NJ 07039
Phone (973) 322-5065

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

Interoperability endpoints

  • Direct secure messaging: pnandigam46078@epicdirect.rwjbh.org

Organizations & group practices 4

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 2

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1457619421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE #207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE #207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIGAM",
        "first_name": "PURNA BINDU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09737700",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA09737700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.