Individual provider Active NPI

Soundari Muralidharan, MD

  • Internal Medicine Physician
  • Brick, NJ
National Provider Identifier
1548363880
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05943100 Issued in NJ
Practice address
970 Route 70
Brick, NJ 08724-3502
Phone
(732) 206-8900
Fax
(732) 836-6001
NPI assigned
Sep 5, 2006
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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 25MA05943100 NJ Primary

Addresses

Primary practice location

970 Route 70
Brick, NJ 08724-3502

Mailing address

970 Route 70
Brick, NJ 08724-3502
Phone (732) 206-8900

Other identifiers 1

IdentifierTypeStateIssuer
5609402MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05943100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Service Fund of Deborah Heart & Lung Center Past Accepting new patients
East Orange Vamc PastSince Dec 1, 2021 Accepting new patients
Professional Service Fund of Deborah- Anesthesia Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1548363880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243502",
            "telephone_number": "732-206-8900",
            "fax_number": "732-836-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243502",
            "telephone_number": "732-206-8900",
            "fax_number": "732-836-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURALIDHARAN",
        "first_name": "SOUNDARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05943100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5609402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.