Individual provider Active NPI

Nisha Varadarajan, MD

  • Dermatology Physician
  • Basking Ridge, NJ
National Provider Identifier
1871939322
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA12485900 Issued in NJ
Practice address
136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone
(855) 955-1019
NPI assigned
May 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA12485900 NJ Primary

Addresses

Primary practice location

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444

Mailing address

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, NJ, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20191028003274 OR Practitioner - Dermatology 6204168008 Reassigns benefits to 1 organization
I20231221000819 WA Practitioner - Dermatology 6204168008 Reassigns benefits to 1 organization
I20250203001890 NJ Practitioner - Dermatology 6204168008 Reassigns benefits to 1 organization
I20250213001326 NY Practitioner - Dermatology 6204168008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
George Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Dermatology GroupGroup PAC ID 1557250818, 19 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

136 Mountain View Blvd
Basking Ridge, NJ 07920-3444

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions203
Skin biopsy175

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 26, 2019 Accepting new patients
Memorial Dermatology Group Dermatology CurrentSince Jan 15, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Dermatology CurrentSince Aug 26, 2019 Accepting new patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey Dermatology CurrentSince Jan 15, 2025 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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 5

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1871939322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MOUNTAINVIEW BLVD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MOUNTAINVIEW BLVD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203444",
            "telephone_number": "855-955-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARADARAJAN",
        "first_name": "NISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA12485900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

Verify at the official NPI Registry.