Jagdish S. Bharara, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA02612700 Issued in NJ

Practice address

1404 Gully Road Gully Rd
Wall Township, NJ 07753

Phone

(732) 245-2202

Fax

(732) 681-7728

NPI assigned

May 3, 2006

Last updated

Nov 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Hackensack Meridian Health Medical Group - Complex Care PC

  dba HMHMG Complex Care

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1649238056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 GULLY ROAD GULLY RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-245-2202",
            "fax_number": "732-681-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 GULLY ROAD GULLY RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-245-2202",
            "fax_number": "732-681-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Grand Avenue",
            "address_purpose": "LOCATION",
            "city": "Asbury Park",
            "state": "NJ",
            "postal_code": "07712",
            "country_code": "US",
            "telephone_number": "732-774-0262",
            "fax_number": "732-775-8963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHARARA",
        "first_name": "JAGDISH",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02612700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford R Beach III, RPH
• Stephen Berchin, D.D.S
• Vladimir Berkovich, MD
• Dawn Berman, APN
• Alexandra Karin Bevacqua
• Judith Andrews Bittner, RN BSN CNOR RNFA
• Jeana Therese Blakeslee
• Diane Bleiman
• Judith Ann Bosco
• Danielle Bosland, DPT

• Pediatrics Physician in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.

Verify at the official NPI Registry.