Active NPI
Samiappan Muthusamy, M.D.
- Gastroenterology Physician
- Union, NJ
National Provider Identifier
1497713184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35548
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100010883 | Other | NJ | RAILROAD MEDICARE |
| 0K7022 | Other | NJ | HEALTHNET |
| 0780901 | Medicaid | NJ | |
| 0033359 | Other | NJ | AETNA |
| P400096 | Other | NJ | OXFORD |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35548 | NJ | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Digestive Diseases, P.a. | Gastroenterology | Current | 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.
-
- Gastroenterology Physician
- Union, NJ
- NPI 1215995923
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.