Individual provider Active NPI

Sai Sujana Surapaneni, PHARMACIST

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1467915660
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03998900 Issued in NJ
Practice address
119 Ocean Ave
Jersey City, NJ 07305-2500
Phone
(201) 432-6968
NPI assigned
Apr 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03998900 NJ Primary

Addresses

Primary practice location

119 Ocean Ave
Jersey City, NJ 07305-2500

Mailing address

425 Washington Blvd Apt 1013
Jersey City, NJ 07310-2045
Phone (516) 288-8198

Other identifiers 1

IdentifierTypeStateIssuer
28RI03998900OtherNJPHARMACIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28RI03998900NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1467915660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WASHINGTON BLVD APT 1013",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073102045",
            "telephone_number": "516-288-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OCEAN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052500",
            "telephone_number": "201-432-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURAPANENI",
        "first_name": "SAI SUJANA",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-13",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03998900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "28RI03998900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; 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.