Individual provider Active NPI

Chandrasekaran Janakiraman, MD

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1780761700
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA10743600 Issued in NJ
Practice address
6 Brighton Rd
Clifton, NJ 07012-1647
Phone
(973) 777-7911
Fax
(973) 777-5403
NPI assigned
Nov 1, 2006
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 182483 NY
Internal Medicine Physician 207R00000X 25MA10743600 NJ Primary

Addresses

Primary practice location

6 Brighton Rd
Clifton, NJ 07012-1647

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other identifiers 2

IdentifierTypeStateIssuer
110234186OtherNYRAILROAD
01513079MedicaidNY

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
I20210827001845 NJ Practitioner - Emergency Medicine 8224019252 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182483NYMDEmergency Medicine Physician
25MA10743600NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Aug 1, 2021 Accepting new patients
Interfaith Emergency Medicine, P.C. Emergency Medicine Past Accepting new patients
Peninsula Medical Services PC Emergency Medicine Past Accepting new patients
South Beach Medical PC Internal Medicine Past Accepting new patients
Lifeco Medical, P.C. Emergency Medicine Past Accepting new patients

Locations

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1780761700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BRIGHTON RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121647",
            "telephone_number": "973-777-7911",
            "fax_number": "973-777-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANAKIRAMAN",
        "first_name": "CHANDRASEKARAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "182483",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10743600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "110234186",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01513079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.