Active NPI
Agrahara Ganeshamurthy, MD
- Internal Medicine Physician
- Edison, NJ
National Provider Identifier
1508966052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MA05924800
- Practice address
- 13 Colasurdo CT
Edison, NJ 08820-4420 - Phone
- (908) 754-6760
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA05924800 | NJ | Primary |
Addresses
Primary practice location
13 Colasurdo CT
Edison, NJ 08820-4420
Mailing address
13 Colasurdo CT
Edison, NJ 08820-4420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0214213 | Medicaid | NJ | |
| P00765897 | Other | NJ | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA05924800 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1508966052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 COLASURDO CT",
"city": "EDISON",
"state": "NJ",
"postal_code": "088204420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 COLASURDO CT",
"city": "EDISON",
"state": "NJ",
"postal_code": "088204420",
"telephone_number": "908-754-6760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANESHAMURTHY",
"first_name": "AGRAHARA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA05924800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0214213",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00765897",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.