Individual provider Active NPI

Angel C Sulse, MD

  • Internal Medicine Physician
  • Woodbridge, NJ
National Provider Identifier
1982779054
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
023119 Issued in NJ
Practice address
423 Amboy Ave
Woodbridge, NJ 07095
Phone
(732) 634-6188
Fax
(732) 634-7991
NPI assigned
Nov 22, 2006
Last updated
Nov 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 023119 NJ Primary
Nephrology Physician 207RN0300X 023119 NJ

Addresses

Primary practice location

423 Amboy Ave
Woodbridge, NJ 07095

Mailing address

423 Amboy Ave
Woodbridge, NJ 07095
Phone (732) 634-6188

Other identifiers 1

IdentifierTypeStateIssuer
2780101MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080729000693 NJ Practitioner - Family PracticePractitioner - Nephrology 1456425172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023119NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edison Nephrorlogy Consultants CurrentSince Apr 26, 2022 Accepting new patients

Locations

36 Progress St
Ste A7
Edison, NJ 08820
Phone (732) 669-0077

2182 Lemoine Ave
Fort Lee, NJ 07024
Phone (201) 482-4705

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1982779054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 AMBOY AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-634-6188",
            "fax_number": "908-769-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 AMBOY AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-634-6188",
            "fax_number": "732-634-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULSE",
        "first_name": "ANGEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "023119",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "023119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2780101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

Verify at the official NPI Registry.