Individual provider Active NPI

Sowmini Kommireddi

  • Pediatrics Physician
  • Holmdel, NJ
National Provider Identifier
1518064260
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA073809 Issued in NJ
Practice address
719 N Beers St Ste 1E
Holmdel, NJ 07733-1523
Phone
(732) 739-4414
Fax
(732) 739-9537
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25MA073809 NJ Primary

Addresses

Primary practice location

719 N Beers St Ste 1E
Holmdel, NJ 07733-1523

Mailing address

719 N Beers St Ste 1E
Holmdel, NJ 07733-1523
Phone (732) 739-4414

Other identifiers 1

IdentifierTypeStateIssuer
9072802MedicaidNJ

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
I20041026000436 NJ Practitioner - Pediatric Medicine 6800857509

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA073809NJMDPreferred Provider Organization

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1518064260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST STE 1E",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331523",
            "telephone_number": "732-739-4414",
            "fax_number": "732-739-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST STE 1E",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331523",
            "telephone_number": "732-739-4414",
            "fax_number": "732-739-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMIREDDI",
        "first_name": "SOWMINI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA073809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9072802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.