NPIMap

Individual provider Active NPI

Shobana Natarajan, M.D.

  • Internal Medicine Physician
  • South Plainfield, NJ
National Provider Identifier
1639174394
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06910100 Issued in NJ
Practice address
904 Oak Tree Ave
Ste M
South Plainfield, NJ 07080-5126
Phone
(908) 757-1414
Fax
(908) 757-3317
NPI assigned
Jun 17, 2005
Last updated
Jan 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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 25MA06910100 NJ Primary

Addresses

Primary practice location

904 Oak Tree Ave
Ste M
South Plainfield, NJ 07080-5126

Mailing address

174 Fleet Ave
Edison, NJ 08820-2430
Phone (732) 205-9660

Other identifiers 14

IdentifierTypeStateIssuer
1000621400OtherNJAMERICHOICE OF NJ
1128842OtherHORIZON NJ HEALTH PLAN
1989550OtherUNITED HEALTHCARE GROUP
2590924OtherGHI
870967000OtherAMERIHEALTH HMO
020613322OtherHORIZON BCBS OF NJ
3695582OtherAETNA HMO
8065004MedicaidNJ
216AY1OtherEMPIRE BCBS
2K3618OtherHEALTHNET
3502595OtherCIGNA
925481OtherAMERIHEALTH PPO
7129105OtherAETNA PPO
P2752621OtherOXFROD HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000620 NJ Practitioner - Internal Medicine 5597667170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Life MD., LLCGroup PAC ID 8426327891, 2 clinicians

Practice addresses (Care Compare)

3840 Park Ave
Suite 103B
Edison, NJ 08820-2563
Phone (732) 515-9944

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06910100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Life MD., LLC Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Neurosurgical Associates of New Jersey, P.C. CurrentSince Jul 1, 2017 Accepting new patients

Locations

3840 Park Ave
Ste 103
Edison, NJ 08820
Phone (732) 515-9944

3840 Park Ave
Ste 103B
Edison, NJ 08820
Phone (732) 372-7085

Interoperability endpoints

  • Direct secure messaging: shobana.natarajan@healthy.ehi.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1639174394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 FLEET AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202430",
            "telephone_number": "732-205-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 OAK TREE AVE",
            "address_2": "STE M",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805126",
            "telephone_number": "908-757-1414",
            "fax_number": "908-757-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATARAJAN",
        "first_name": "SHOBANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06910100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE OF NJ",
            "identifier": "1000621400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH PLAN",
            "identifier": "1128842",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE GROUP",
            "identifier": "1989550",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2590924",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "870967000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BCBS OF NJ",
            "identifier": "020613322",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3695582",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8065004",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "216AY1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K3618",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3502595",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "925481",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7129105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFROD HEALTH PLAN",
            "identifier": "P2752621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Plainfield, NJ

Sources for this page

Verify at the official NPI Registry.