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DR. DARSHI SUNDERAM MD
NPI 1679597280
Internal Medicine in East Orange, NJ

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
310 CENTRAL AVE, SUITE 205, EAST ORANGE, NJ 07018(973) 266-9111(973) 266-1227 Get Directions Write a Review

NPPES record last updated: June 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Darshi Sunderam Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DARSHI SUNDERAM MD (NPI 1679597280) is an individual internal medicine provider in East Orange, New Jersey, licensed in New Jersey (25MA04656000) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Carewell Health Medical Center, and is a graduate of Other (1976).

NPPES Registry Identity

NPI1679597280
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. DARSHI SUNDERAMCredential: MD
Location Address310 CENTRAL AVE, SUITE 205East Orange, NJ 07018-2835
Mailing Address310 Central Ave, Suite 205East Orange, NJ 07018-2835 · (973) 266-9111 · Fax (973) 266-1227
Phone(973) 266-9111
Fax(973) 266-1227
Sole ProprietorYes
Medical School CMSOtherGraduated 1976
Enumeration DateJuly 27, 2006
Last NPPES UpdateJune 10, 2024
NPPES CertifiedJune 10, 2024
✔ NPI 1679597280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA04656000
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X · License 25MA04656000 (NJ)
310 CENTRAL AVE, East Orange, NJ 07018
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Other Identifiers 1

Medicaid1885006NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Darshi Sunderam Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830115302
PECOS Enrollment IDI20051024000669
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
721 services123 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
494 services98 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
315 services79 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
281 services64 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
92 services78 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
72 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carewell Health Medical Center

Acute Care Hospitals · East Orange, NJ
1/5 CMS rating
OwnershipProprietary
CMS Certification Number310083
Location300 Central AveEast Orange, NJ 07018 · Essex County
Emergency services

Saint Michael's Medical Center

Acute Care Hospitals · Newark, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310096
Location111 Central AvenueNewark, NJ 07102 · Essex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07018 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality93.99
Improvement Activities40
Cost44

Reported Quality Measures

Controlling High Blood Pressure
80%699 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%5,462 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
99%968 patients5/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
59%314 patients4/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 88% · 864 patients
Patients screened: 99% · 864 patients
2%101 patients1/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
80%106 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 5% · 409 patients
2%409 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
23 suppliers85 claims203 services$5.73 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
18 suppliers35 claims51 services$1.05 avg. paid by Medicare
Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier11 claims360 services$6.34 avg. paid by Medicare
Tracheostomy care kit for established tracheostomy A4629
DME-Orthotic Devices · category DF000N
1 supplier11 claims360 services$4.35 avg. paid by Medicare
Tracheostomy tube collar/holder, each A7526
DME-Orthotic Devices · category DF000N
1 supplier11 claims120 services$3.28 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier14 claims358 services$4.28 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VICTOR T VERLEZZA D.C.
Chiropractor
310 CENTRAL AVE, SUITE 307
EAST ORANGE, NJ 07018
Essex County (973) 266-7860
DR. NABEEL OBAID MD
Internal Medicine (Infectious Disease)
310 CENTRAL AVE, SUITE 102
EAST ORANGE, NJ 07018
Essex County (201) 512-9494
LIANMED INC
Internal Medicine (Infectious Disease)
310 CENTRAL AVE, SUITE 102
EAST ORANGE, NJ 07018
Essex County (201) 512-9494
ESSEX VALLEY SPINE CARE PC
Chiropractor (Rehabilitation)
310 CENTRAL AVE, SUITE 307
EAST ORANGE, NJ 07018
Essex County (973) 266-7860
SMITH CENTER FOR INFECTIOUS DISEASES AND URBAN HEALTH, P.A.
Voluntary or Charitable
310 CENTRAL AVE, SUITE 307- TIMESHARE
EAST ORANGE, NJ 07018
Essex County (973) 809-4550
ORANGE MEDICAL GROUP PA
Internal Medicine (Hematology & Oncology)
310 CENTRAL AVE, SUITE 106
EAST ORANGE, NJ 07018
Essex County (973) 674-4542
EAST ORANGE PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
310 CENTRAL AVE, STE 111
EAST ORANGE, NJ 07018
Essex County (973) 674-5777
A1 MEDICAL CARE PC
Clinic/Center (Primary Care)
310 CENTRAL AVE, SUITE 310
EAST ORANGE, NJ 07018
Essex County (973) 678-2900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Darshi Sunderam's NPI number?

The NPI number for Darshi Sunderam is 1679597280. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Darshi Sunderam located?

Darshi Sunderam practices at 310 Central Ave Suite 205, East Orange, NJ 07018. The listed phone number is (973) 266-9111.

What is Darshi Sunderam's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Darshi Sunderam enrolled in Medicare?

Yes. Darshi Sunderam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Darshi Sunderam accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Darshi Sunderam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Darshi Sunderam affiliated with any hospitals?

According to CMS data, Darshi Sunderam is affiliated with Carewell Health Medical Center and Saint Michael's Medical Center.

When was this NPI record last updated?

The NPPES record for Darshi Sunderam was last updated on June 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.