Active NPI
Sushila Varadarajan, M.D.
- Specialist
- Vineland, NJ
National Provider Identifier
1720003676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25 MA03141300
- Practice address
- 1505 W Sherman Ave
Vineland, NJ 08360-6912 - Phone
- (856) 641-8000
- Fax
- (856) 641-7623
- NPI assigned
- Jul 13, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 25 MA03141300 | NJ | Primary |
Addresses
Primary practice location
1505 W Sherman Ave
Vineland, NJ 08360-6912
Mailing address
PO Box 754
Millville, NJ 08332-0754
Phone (856) 690-1025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5203601 | Medicaid | NJ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25 MA03141300 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Jersey Health System Emergency Physician Services P a | 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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Elmer, NJ
- NPI 1306871314
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720003676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 754",
"city": "MILLVILLE",
"state": "NJ",
"postal_code": "083320754",
"telephone_number": "856-690-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 W SHERMAN AVE",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083606912",
"telephone_number": "856-641-8000",
"fax_number": "856-641-7623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARADARAJAN",
"first_name": "SUSHILA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25 MA03141300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5203601",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.