Individual provider Active NPI

Samiappan Muthusamy, M.D.

  • Gastroenterology Physician
  • Union, NJ
National Provider Identifier
1497713184
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35548 Issued in NJ
Practice address
695 Chestnut St
Union, NJ 07083-9302
Phone
(908) 688-6565
Fax
(908) 688-3161
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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 35548 NJ Primary

Addresses

Primary practice location

695 Chestnut St
Union, NJ 07083-9302

Mailing address

695 Chestnut St
Union, NJ 07083-9302
Phone (908) 688-6565

Other identifiers 5

IdentifierTypeStateIssuer
100010883OtherNJRAILROAD MEDICARE
0K7022OtherNJHEALTHNET
0780901MedicaidNJ
0033359OtherNJAETNA
P400096OtherNJOXFORD

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
I20081205000436 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 5991608812 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35548NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Digestive Diseases, P.a. Gastroenterology CurrentSince Jan 1, 1989 Accepting new patients

Locations

695 Chestnut St
Union, NJ 07083
Phone (908) 688-6565

1201 Morris Ave
Union, NJ 07083
Phone (908) 686-0066

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1497713184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839302",
            "telephone_number": "908-688-6565",
            "fax_number": "908-688-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839302",
            "telephone_number": "908-688-6565",
            "fax_number": "908-688-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUSAMY",
        "first_name": "SAMIAPPAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "35548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100010883",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0K7022",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0780901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0033359",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P400096",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.