Active NPI
Subha Jyothi Kukkala, NP
- Nurse Practitioner
- East Windsor, NJ
National Provider Identifier
1649025909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 26NJ14971700
- Practice address
- 59 One Mile Rd Ext FL 2
East Windsor, NJ 08520-2505 - Phone
- (844) 337-6362
- NPI assigned
- Apr 20, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NJ14971700 | NJ | Primary |
Addresses
Primary practice location
59 One Mile Rd Ext FL 2
East Windsor, NJ 08520-2505
Mailing address
33 E 33Rd St FL 12
New York, NY 10016-5362
Phone (929) 501-0535
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713571200000",
"number": "1649025909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 E 33RD ST FL 12",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165362",
"telephone_number": "929-501-0535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 ONE MILE RD EXT FL 2",
"city": "EAST WINDSOR",
"state": "NJ",
"postal_code": "085202505",
"telephone_number": "844-337-6362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKKALA",
"first_name": "SUBHA",
"middle_name": "JYOTHI",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-20",
"last_updated": "2024-04-20",
"certification_date": "2024-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "26NJ14971700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Windsor, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.