NPIMap

Individual provider Active NPI

Sandira V Segaram, M.D., F.A.C.P.

  • Internal Medicine Physician
  • Hackettstown, NJ
National Provider Identifier
1508813346
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05040500 Issued in NJ
Practice address
653 Willow Grove St
Suite 1600
Hackettstown, NJ 07840-1732
Phone
(908) 813-2888
Fax
(908) 813-2521
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05040500 NJ Primary

Addresses

Primary practice location

653 Willow Grove St
Suite 1600
Hackettstown, NJ 07840-1732

Mailing address

653 Willow Grove St
Suite 1600
Hackettstown, NJ 07840-1732
Phone (908) 813-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000542 NJ Practitioner - Internal Medicine 0446341127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

121 Shelley Dr
Suite 1F
Hackettstown, NJ 07840-2530
Phone (908) 813-2888

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandira V Segaram MD LLC Internal Medicine CurrentSince Jul 19, 2006 Accepting new patients

Locations

121 Shelley Dr
Ste 1F
Hackettstown, NJ 07840
Phone (908) 813-2888

653 Willow Grove St
Ste 1600
Hackettstown, NJ 07840
Phone (908) 813-2888

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Little Brook Nursing and Convalescent HomeCalifon, NJ, CCN 315467 Skilled nursing facility Corporate Director
Operational/Managerial Control
Adp of the SNF		 Dec 30, 2005
Dec 30, 2005
Dec 30, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Little Brook Home Inc.

    dba Little Brook Nursing and Convalescent Home

    • Skilled Nursing Facility
    • Califon, NJ
    • NPI 1154372969

    Adp of the SNF, Corporate Director, Operational/Managerial Control

    CMS ownership

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 and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1508813346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 WILLOW GROVE ST",
            "address_2": "SUITE 1600",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401732",
            "telephone_number": "908-813-2888",
            "fax_number": "908-813-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 WILLOW GROVE ST",
            "address_2": "SUITE 1600",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401732",
            "telephone_number": "908-813-2888",
            "fax_number": "908-813-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGARAM",
        "first_name": "SANDIRA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05040500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

Verify at the official NPI Registry.