Etukuru MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ETUKURU MD PC

Practice address

1001 Center St
Little Egg Harbor TWP, NJ 08087-1347

Phone

(609) 296-9292

NPI assigned

Feb 16, 2024

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kasturi Etukuru, MDNPI 1912117300

Title

Owner

Phone

(718) 702-6139

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kasturi Etukuru, M.D.,

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1912117300

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1780449868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PREAKNESS DR",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088317711",
            "telephone_number": "718-702-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CENTER ST",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080871347",
            "telephone_number": "609-296-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETUKURU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "ETUKURU",
        "authorized_official_first_name": "KASTURI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-702-6139",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John S Ellis, OD
• Ellis' Family Eyecare, LLC
• Encore Preakness, Inc.
• Equilibrium Rehab, LLC
• Essence of Life Therapeutic Services LLC
• Family Medicine Center (Family Medicine Center - Little Egg Harbor)
• Lauren Farina
• Harold Ferraren, PT
• James Finocchi, RPH
• First Hands Surgical Services LLC

• Internal Medicine Physician in Little Egg Harbor TWP, NJ
• Providers in Little Egg Harbor TWP, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.