NPIMap

Individual provider Active NPI

Darshi Sunderam, MD

  • Internal Medicine Physician
  • East Orange, NJ
National Provider Identifier
1679597280
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04656000 Issued in NJ
Practice address
310 Central Ave
Suite 205
East Orange, NJ 07018-2835
Phone
(973) 266-9111
Fax
(973) 266-1227
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA04656000 NJ
Internal Medicine Physician 207R00000X 25MA04656000 NJ Primary

Addresses

Primary practice location

310 Central Ave
Suite 205
East Orange, NJ 07018-2835

Mailing address

310 Central Ave
Suite 205
East Orange, NJ 07018-2835
Phone (973) 266-9111

Other identifiers 1

IdentifierTypeStateIssuer
1885006MedicaidNJ

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
I20051024000669 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 9830115302 Reassigns benefits to 2 organizations
Practice locations: East Orange, NJ

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Avenue Professional Services, PCGroup PAC ID 7214258003, 49 clinicians

Practice addresses (Care Compare)

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5300

59 Koch Ave
Morris Plains, NJ 07950-4400
Phone (973) 538-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.64 of 100Reported as individual
Quality
76.67
Improvement activities
40
Cost
76.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04656000NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Avenue Professional Services, PC CurrentSince Jan 30, 2024 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Nov 3, 2004 Accepting new patients
Eoh Acquisition Group, LLC Past Accepting new patients
Gnana Sunderam MD; PC Specialist Past Accepting new patients
Prime Healthcare Services - St Michaels LLC Past Accepting new patients

Locations

59 Koch Ave
Morris Plains, NJ 07950
Phone (973) 889-4390

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1679597280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVE",
            "address_2": "SUITE 205",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182835",
            "telephone_number": "973-266-9111",
            "fax_number": "973-266-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVE",
            "address_2": "SUITE 205",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182835",
            "telephone_number": "973-266-9111",
            "fax_number": "973-266-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERAM",
        "first_name": "DARSHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA04656000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04656000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1885006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.