Individual provider Active NPI

Praneetha Puskuri, MD

  • Internal Medicine Physician
  • Bridgewater, NJ
National Provider Identifier
1851581656
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M9589 Issued in TX
Practice address
22 Reinhart Way
Bridgewater, NJ 08807-5710
Phone
(732) 309-1040
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08271100 NJ
Internal Medicine Physician 207R00000X M9589 TX Primary

Addresses

Primary practice location

22 Reinhart Way
Bridgewater, NJ 08807-5710

Mailing address

22 Reinhart Way
Bridgewater, NJ 08807-5710
Phone (732) 309-1040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000606 TX Practitioner - HospitalistPractitioner - Nephrology 4082894373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas - Burnet PLLCGroup PAC ID 1850831637, 76 clinicians

Practice addresses (Care Compare)

5016 S US Hwy 75
Texoma Medical Center
Denison, TX 75020-4584
Phone (903) 416-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08271100NJMDInternal Medicine Physician
M9589TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas - Burnet PLLC Internal Medicine CurrentSince Jul 24, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jun 15, 2015 Accepting new patients
KNJ Hospitalist Group LLC Past Accepting new patients
Uhs of Texoma, Inc Past Accepting new patients
Florida Nephrology PLC PastSince Jul 2, 2012 Accepting new patients

Locations

5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

1498 Pacific Ave
Ste 500
Tacoma, WA 98402
Phone (253) 682-6040

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 and National Provider Directory roles.

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1851581656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 REINHART WAY",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075710",
            "telephone_number": "732-309-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 REINHART WAY",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075710",
            "telephone_number": "732-309-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSKURI",
        "first_name": "PRANEETHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08271100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.