Organization Active NPI

John S. Rajapakse, MD PA

  • Internal Medicine Physician
  • Perth Amboy, NJ
National Provider Identifier
1851676936
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA0282773000 Issued in NJ
Legal business name
JOHN S. RAJAPAKSE, MD PA
Practice address
495 New Brunswick Ave
Perth Amboy, NJ 08861-3653
Phone
(732) 442-4422
Fax
(732) 442-3577
NPI assigned
Oct 20, 2011
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
John S Rajapakse, MDNPI 1639377914
Title
Ceo
Phone
(732) 442-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA0282773000 NJ Primary

Addresses

Primary practice location

495 New Brunswick Ave
Perth Amboy, NJ 08861-3653

Mailing address

495 New Brunswick Ave
Perth Amboy, NJ 08861-3653
Phone (732) 442-4422

Other identifiers 1

IdentifierTypeStateIssuer
0140449MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000698 NJ Part B Supplier - Clinic/Group Practice 0749448264 Receives reassigned benefits from 1 practitioner
Practice locations: Perth Amboy, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2031785John S Rajapakse, MD PA495 New Brunswick Ave, Perth Amboy, NJ 08861Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Locations

495 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 442-4422

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1851676936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613653",
            "telephone_number": "732-442-4422",
            "fax_number": "732-442-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613653",
            "telephone_number": "732-442-4422",
            "fax_number": "732-442-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S. RAJAPAKSE, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "RAJAPAKSE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-442-4422",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA0282773000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0140449",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.