Individual provider Active NPI

Pramod K Pabbathi, D.O.

  • Anesthesiology Physician
  • Somerset, NJ
National Provider Identifier
1770690158
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MB08806800 Issued in NJ
Practice address
285 Davidson Ave
Suite 204
Somerset, NJ 08873-4153
Phone
(732) 217-1400
Fax
(732) 271-3544
NPI assigned
Aug 23, 2006
Last updated
Jun 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MB08806800 NJ Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X MB08806800 NJ
Pediatric Anesthesiology Physician 207LP3000X 25MB08806800 NJ

Addresses

Primary practice location

285 Davidson Ave
Suite 204
Somerset, NJ 08873-4153

Mailing address

285 Davidson Ave
Suite 204
Somerset, NJ 08873-4153
Phone (732) 217-1400

Other identifiers 1

IdentifierTypeStateIssuer
0376272MedicaidNJ

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
I20130919000107 NJ Practitioner - AnesthesiologyPractitioner - Pain Management 9234224445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New England, College of Osteo Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2100 Wescott Dr
Flemington, NJ 08822-4603
Phone (908) 300-3700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB08806800NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elevated Anesthesia Solutions Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
Sanjay D Rao MD LLC PastSince Jan 3, 2022 Accepting new patients

Locations

1121 US Highway 22
Bridgewater, NJ 08807
Phone (908) 237-4109

2100 Wescott Dr
Flemington, NJ 08822
Phone (908) 237-5420

Interoperability endpoints

  • Direct secure messaging: ppabbathi53715@epicdirect.rwjbh.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1770690158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 DAVIDSON AVE",
            "address_2": "SUITE 204",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734153",
            "telephone_number": "732-217-1400",
            "fax_number": "732-271-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 DAVIDSON AVE",
            "address_2": "SUITE 204",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734153",
            "telephone_number": "732-217-1400",
            "fax_number": "732-271-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABBATHI",
        "first_name": "PRAMOD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MB08806800",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "MB08806800",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NJ",
            "license": "25MB08806800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0376272",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.