Individual provider Active NPI

Radhika Radhakrishnan, MD

  • Anesthesiology Physician
  • Summit, NJ
National Provider Identifier
1740387984
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07718800 Issued in NJ
Practice address
33 Overlook Rd
Suite 311
Summit, NJ 07901-3570
Phone
(908) 598-1500
Fax
(908) 598-0197
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07718800 NJ Primary

Addresses

Primary practice location

33 Overlook Rd
Suite 311
Summit, NJ 07901-3570

Mailing address

PO Box 48078
Newark, NJ 07101-4878

Other identifiers 1

IdentifierTypeStateIssuer
0036862MedicaidNJ

Other names 1

  • Radhika Gopal Former name

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
I20040909001340 NJ Practitioner - Anesthesiology 6507832565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

187 Millburn Ave
Millburn, NJ 07041-1847
Phone (973) 671-0555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07718800NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Apr 16, 2020 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

187 Millburn Ave
Millburn, NJ 07041
Phone (973) 467-1466

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1740387984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48078",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD",
            "address_2": "SUITE 311",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013570",
            "telephone_number": "908-598-1500",
            "fax_number": "908-598-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADHAKRISHNAN",
        "first_name": "RADHIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07718800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036862",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADHIKA",
            "last_name": "GOPAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.