Individual provider Active NPI

Satyeswara Krishnappa Sarode, MD

  • Internal Medicine Physician
  • North Brunswick, NJ
National Provider Identifier
1720045917
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04994400 Issued in NJ
Practice address
1520 Hwy 130
Suite 202
North Brunswick, NJ 08902-3145
Phone
(732) 422-0212
Fax
(732) 348-8003
NPI assigned
May 1, 2006
Last updated
May 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2019

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 25MA04994400 NJ Primary

Addresses

Primary practice location

1520 Hwy 130
Suite 202
North Brunswick, NJ 08902-3145

Mailing address

1520 Hwy 130
Suite 202
No Brunswick, NJ 08902-3145
Phone (732) 422-0212

Other identifiers 2

IdentifierTypeStateIssuer
5296501MedicaidNJ
10701023OtherCAQH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040512001214 NJ Practitioner - Internal Medicine 1850381989 Practice locations: North Brunswick, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04994400NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1720045917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 HWY 130",
            "address_2": "SUITE 202",
            "city": "NO BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023145",
            "telephone_number": "732-422-0212",
            "fax_number": "732-422-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 HWY 130",
            "address_2": "SUITE 202",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023145",
            "telephone_number": "732-422-0212",
            "fax_number": "732-348-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARODE",
        "first_name": "SATYESWARA",
        "middle_name": "KRISHNAPPA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04994400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5296501",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10701023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.