Active NPI
Raghu Gudapati, MD
- Internal Medicine Physician
- Tinton Falls, NJ
National Provider Identifier
1629087622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA05811900
- Practice address
- 3000 Essex Rd
Tinton Falls, NJ 07753 - Phone
- (732) 643-2070
- Fax
- (732) 643-2015
- NPI assigned
- Aug 7, 2006
- Last updated
- Jul 18, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 25MA05811900 | NJ | Primary |
Addresses
Primary practice location
3000 Essex Rd
Tinton Falls, NJ 07753
Mailing address
5525 Research Park Dr FL 4
Baltimore, MD 21228-4873
Phone (732) 643-2070
Other practice location 1
970 route 70
brick, NJ 08724
Phone (732) 836-6022
Other practice location 2
970 route 70
brick, NJ 08724
Phone (732) 836-6022
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Orange Vamc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Department of Veterans Affairs (VA) Pharmacy
- Toms River, NJ
- NPI 1780632802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1629087622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5525 RESEARCH PARK DR FL 4",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212284873",
"telephone_number": "732-643-2070",
"fax_number": "732-643-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 ESSEX RD",
"city": "TINTON FALLS",
"state": "NJ",
"postal_code": "07753",
"telephone_number": "732-643-2070",
"fax_number": "732-643-2015"
}
],
"practiceLocations": [
{
"address_1": "970 route 70",
"address_purpose": "LOCATION",
"city": "brick",
"state": "NJ",
"postal_code": "08724",
"country_code": "US",
"telephone_number": "732-836-6022",
"fax_number": "732-836-6001",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "970 route 70",
"address_purpose": "LOCATION",
"city": "brick",
"state": "NJ",
"postal_code": "08724",
"country_code": "US",
"telephone_number": "732-836-6022",
"fax_number": "732-836-6001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUDAPATI",
"first_name": "RAGHU",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA05811900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinton Falls, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.