Individual provider Active NPI

Tinchu Ruby Varghese

  • Family Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1972440543
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP035559 Issued in PA
Practice address
1999 Cedarbridge Ave
Lakewood, NJ 08701-7048
Phone
(401) 585-9573
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP035559 PA Primary

Addresses

Primary practice location

1999 Cedarbridge Ave
Lakewood, NJ 08701-7048

Mailing address

425 Jonathan PL
Philadelphia, PA 19115-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260608004158 PA Practitioner - Nurse Practitioner 2769953991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

425 Jonathan PL
Philadelphia, PA 19115-1808

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP035559PAMDFamily Nurse Practitioner

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": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1972440543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JONATHAN PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 CEDARBRIDGE AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017048",
            "telephone_number": "401-585-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY VARGHESE",
        "first_name": "TINCHU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP035559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.