Organization Active NPI

Center for Infectious Diseases and Intl. Travel Care of Monmouth, P.C.

  • Medical Specialty Clinic/Center
  • Freehold, NJ
National Provider Identifier
1497929038
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
25MA07472000 Issued in NJ
Legal business name
CENTER FOR INFECTIOUS DISEASES AND INTL. TRAVEL CARE OF MONMOUTH, P.C.
Practice address
901 West Main Street Suite 260,
CN 5050,
Freehold, NJ 07728
Phone
(732) 685-9243
Fax
(732) 631-9924
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Dr. Ramanasri V. Kudipudi, M.D.NPI 1447325311
Title
President
Phone
(732) 685-9243

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 25MA07472000 NJ Primary
General Acute Care Hospital 282N00000X 25MA07472000 NJ

Addresses

Primary practice location

901 West Main Street Suite 260,
CN 5050,
Freehold, NJ 07728

Mailing address

31 Yellow Brook Rd
Holmdel, NJ 07733-1967
Phone (732) 682-9763

Other identifiers 1

IdentifierTypeStateIssuer
8972401MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080430000022 NJ Part B Supplier - Clinic/Group Practice 8527147768 Receives reassigned benefits from 1 practitioner
Practice locations: Freehold, NJ

National Provider Directory

National Provider Directory

Locations

901 W Main St
Ste 260CN5050
Freehold, NJ 07728

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1497929038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 YELLOW BROOK RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331967",
            "telephone_number": "732-682-9763",
            "fax_number": "732-631-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WEST MAIN STREET SUITE 260,",
            "address_2": "CN 5050,",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-685-9243",
            "fax_number": "732-631-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INFECTIOUS DISEASES AND INTL. TRAVEL CARE OF MONMOUTH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "KUDIPUDI",
        "authorized_official_first_name": "RAMANASRI",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-685-9243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA07472000",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NJ",
            "license": "25MA07472000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8972401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.