Renjini Raju Basil

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00360600 Issued in NJ

Practice address

202 Howard Drive
Apt # I
Bergenfield, NJ 07621

Phone

(201) 385-0538

NPI assigned

Jan 18, 2012

Last updated

Jan 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Medical Providers LLCGroup PAC ID 3971973702, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Main Street Medical Providers LLC

  • Internal Medicine Physician
  • Parsippany, NJ
  • NPI 1790497444
  Medicare reassignment Care Compare group NPD
• Pradip S Shah, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • West Caldwell, NJ
  • NPI 1326059320
  Medicare reassignment
• Pradip S. Shah, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • West Caldwell, NJ
  • NPI 1558557124
  NPD (past)

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1790056182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HOWARD DRIVE",
            "address_2": "APT # I",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-385-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HOWARD DRIVE",
            "address_2": "APT # I",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-385-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASIL",
        "first_name": "RENJINI",
        "middle_name": "RAJU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00360600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talia Bachrach, DPT
• Arien Bahawdory, DMD
• Dulce M Balcacer, PA-C
• Tiffany Carmel Toledo Balico, MSN RNFNP-BC CCRN
• Barpak Geriatric Health Services Inc
• Sanjukta Basu, PHARMD
• Kristin Gabrielle Bauroth, PNP-PC
• Rowena Bautista, APN
• Lanelle Bayla
• Alfonso E Bayuelo, DDS

• Family Nurse Practitioner in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.