Organization Active NPI

Jersey Medical Associates Inc

  • Internal Medicine Physician
  • Old Bridge, NJ
National Provider Identifier
1912060930
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07380600 Issued in NJ
Legal business name
JERSEY MEDICAL ASSOCIATES INC
Practice address
200,Perrine Road,Suite 206,Old Bridge Prof.Plaza
Old Bridge, NJ 07751
Phone
(732) 952-5693
Fax
(732) 952-5694
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vinutha Rajasekharaiah, M.D
Title
Owner
Phone
(732) 952-5693

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA07380600 NJ Primary

Addresses

Primary practice location

200,Perrine Road,Suite 206,Old Bridge Prof.Plaza
Old Bridge, NJ 07751

Mailing address

200,Perrine Road,Suite 206,Old Bridge Prof.Plaza
Old Bridge, NJ 07751
Phone (732) 952-5693

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111000285 NJ Part B Supplier - Clinic/Group Practice 4385667096 Receives reassigned benefits from 1 practitioner
Practice locations: Hazlet, NJ

National Provider Directory

National Provider Directory

Locations

80 Hazlet Ave
Ste 10
Hazlet, NJ 07730
Phone (732) 264-0400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912060930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200,PERRINE ROAD,SUITE 206,OLD BRIDGE PROF.PLAZA",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "07751",
            "telephone_number": "732-952-5693",
            "fax_number": "732-952-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200,PERRINE ROAD,SUITE 206,OLD BRIDGE PROF.PLAZA",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "07751",
            "telephone_number": "732-952-5693",
            "fax_number": "732-952-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAJASEKHARAIAH",
        "authorized_official_first_name": "VINUTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-952-5693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07380600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.