Individual provider Active NPI

Arunasree Dubbaka-Rajaram, MD

  • Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1558515213
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08449600 Issued in NJ
Practice address
142 Palisade Ave
Jersey City, NJ 07306-1133
Phone
(201) 479-5206
NPI assigned
Nov 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 003257 NY
Pediatrics Physician 208000000X 25MA08449600 NJ Primary

Addresses

Primary practice location

142 Palisade Ave
Jersey City, NJ 07306-1133

Mailing address

142 Palisade Ave
Jersey City, NJ 07306-1133
Phone (201) 479-5206

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
I20120725000199 NJ Practitioner - Pediatric Medicine 2062678766 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08449600NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Dec 1, 2018 Accepting new patients
Optum Medical Care of New Jersey PC Pediatrics CurrentSince Dec 1, 2018 Accepting new patients
Hudson Premier Medical PC CurrentSince Apr 1, 2021 Accepting new patients
House Physician Partners, PC CurrentSince Oct 29, 2023 Accepting new patients
Jersey City Medical Center Past Accepting new patients
Holy Name Medical Center Inc. Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1558515213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061133",
            "telephone_number": "201-479-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061133",
            "telephone_number": "201-479-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBAKA-RAJARAM",
        "first_name": "ARUNASREE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "003257",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08449600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.