Individual provider Active NPI

Meena Kalyanaraman, MD

  • Pediatric Critical Care Medicine Physician
  • Newark, NJ
National Provider Identifier
1821174558
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA07483000 Issued in NJ
Practice address
201 Lyons Ave # C-5
Newark, NJ 07112-2027
Phone
(973) 926-7659
Fax
(973) 926-6452
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07483000 NJ
Pediatric Critical Care Medicine Physician 2080P0203X 25MA07483000 NJ Primary

Addresses

Primary practice location

201 Lyons Ave # C-5
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave # C-5
Newark, NJ 07112-2027
Phone (973) 926-7659

Other identifiers 1

IdentifierTypeStateIssuer
8952400MedicaidNJ

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
I20070406000039 NJ Practitioner - Pediatric Medicine 7214031962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07483000NJMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Oct 28, 2023 Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
#C5
Newark, NJ 07112
Phone (973) 926-6770

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
Ste C9
Newark, NJ 07112
Phone (973) 926-7203

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: mkalyanaraman229335@epicdirect.rwjbh.org

Organizations & group practices 3

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1821174558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE # C-5",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7659",
            "fax_number": "973-926-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE # C-5",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7659",
            "fax_number": "973-926-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALYANARAMAN",
        "first_name": "MEENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07483000",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA07483000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8952400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.