Active NPI
Nagarathna Prabhuram, M.D.
- Pediatrics Physician
- North Brunswick, NJ
National Provider Identifier
1891930947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA08471400
- Practice address
- 2864 Rte 27
Suite a
North Brunswick, NJ 08902 - Phone
- (732) 940-4134
- Fax
- (732) 960-3720
- NPI assigned
- Dec 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA08471400 | NJ | Primary |
Addresses
Primary practice location
2864 Rte 27
Suite a
North Brunswick, NJ 08902
Mailing address
27 Crestview Dr
Kendall Park, NJ 08824
Phone (732) 331-3046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08471400 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Health Initiatives | Past | Accepting new patients |
Interoperability endpoints
- nagarathna.prabhuram.1@11915.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Lakewood, NJ
- NPI 1710980917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1891930947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 CRESTVIEW DR",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "08824",
"telephone_number": "732-331-3046",
"fax_number": "732-960-3720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2864 RTE 27",
"address_2": "SUITE A",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "08902",
"telephone_number": "732-940-4134",
"fax_number": "732-960-3720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRABHURAM",
"first_name": "NAGARATHNA",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-03",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA08471400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Brunswick, NJ
- Anthony Porreca, BCBA
- Positive Health Center LLC
- Diane Potash, APN
- Haritha Potluri, M.D
- David M Potter, D.C.
- Practice Home Care Services Inc (Homewatch Caregivers)
- Precision Spine & Sports Medicine
- Preferred Home Health Care & Nursing Services
- Preferred Home Health Care & Nursing Services, Inc. (Care Options for Kids)
- Preferred Nursing and Staffing Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.