Individual provider Active NPI

Ritu Khullar, M.D.

  • Pediatrics Physician
  • Colts Neck, NJ
National Provider Identifier
1912167701
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08909400 Issued in NJ
Practice address
9 Professional Cir Ste 103
Colts Neck, NJ 07722-2427
Phone
(848) 300-0010
Fax
(732) 440-3737
NPI assigned
Jun 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08909400 NJ Primary

Addresses

Primary practice location

9 Professional Cir Ste 103
Colts Neck, NJ 07722-2427

Mailing address

9 Professional Cir Ste 103N
Colts Neck, NJ 07722-2427
Phone (848) 300-0010

Other identifiers 2

IdentifierTypeStateIssuer
25MA08909400OtherNJNJ LICENSE
0290467MedicaidNJ

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

LicenseStateTypeSpecialty
25MA08909400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goldstar Pediatrics, LLC Pediatrics CurrentSince Apr 9, 2023 Accepting new patients

Locations

9 Professional Cir
Ste 103N
Colts Neck, NJ 07722

9 Professional Cir
Ste 103
Colts Neck, NJ 07722
Phone (732) 462-5200

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

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.

NPI Registry JSON

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1912167701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL CIR STE 103N",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222427",
            "telephone_number": "848-300-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL CIR STE 103",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222427",
            "telephone_number": "848-300-0010",
            "fax_number": "732-440-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHULLAR",
        "first_name": "RITU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-15",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08909400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "25MA08909400",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290467",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.