Individual provider Active NPI

Prasad R Medavarapu

  • Pharmacist
  • Lumberton, NJ
National Provider Identifier
1619134103
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RJ03194 Issued in NJ
Practice address
1613 Route 38
Lumberton, NJ 08048-2921
Phone
(609) 914-4890
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPI000736 PA
Pharmacist 183500000X 28RJ03194 NJ Primary

Addresses

Primary practice location

1613 Route 38
Lumberton, NJ 08048-2921

Mailing address

1613 Route 38
Lumberton, NJ 08048-2921
Phone (609) 914-4890

Other practice location 1

1601 Kings Hwy N Ste 400
Cherry Hill, NJ 08034-2309
Phone (856) 428-5888

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28RJ03194NJMDPharmacist
RPI000736PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medscare LLC Pharmacist CurrentSince Oct 12, 2025 Accepting new patients
Medscare LLC CurrentSince Jul 16, 2023 Accepting new patients

Locations

1601 Kings Hwy N
Ste 400
Cherry Hill, NJ 08034
Phone (856) 428-5888

Organizations & group practices 2

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1619134103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482921",
            "telephone_number": "609-914-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482921",
            "telephone_number": "609-914-4890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Kings Hwy N Ste 400",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342309",
            "country_code": "US",
            "telephone_number": "856-428-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDAVARAPU",
        "first_name": "PRASAD",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RPI000736",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RJ03194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.