Organization Active NPI

Ushapanicker Mdllc

  • Endocrinology, Diabetes & Metabolism Physician
  • Edison, NJ
National Provider Identifier
1912989757
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
USHAPANICKER MDLLC
Practice address
2 Maryland Ave
Edison, NJ 08820-2551
Phone
(732) 744-9288
NPI assigned
Nov 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Usha R Panicker, M.D.NPI 1437131786
Title
Sole Owner
Phone
(732) 744-9288

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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

2 Maryland Ave
Edison, NJ 08820-2551

Mailing address

2 Maryland Ave
Edison, NJ 08820-2551
Phone (732) 744-9288

Other identifiers 5

IdentifierTypeStateIssuer
10202700OtherNJHORIZON NJ HEALTH
LP195OtherNJOXFORD
1K6836OtherNJHEALTHNET
2421743OtherNJAETNA
8371202MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050323000167 NJ Part B Supplier - Clinic/Group Practice 8820044902 Receives reassigned benefits from 2 practitioners
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

2 Maryland Ave
Edison, NJ 08820
Phone (732) 744-9288

Practitioners & affiliated clinicians

Practitioners 2

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": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1912989757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MARYLAND AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202551",
            "telephone_number": "732-744-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MARYLAND AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202551",
            "telephone_number": "732-744-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USHAPANICKER MDLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PANICKER",
        "authorized_official_first_name": "USHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "732-744-9288",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "10202700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "LP195",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K6836",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2421743",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8371202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.