Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kannan Sivaraju

Individual provider Geriatric Medicine (Internal Medicine) Physician · NPI 1659508687

Kannan Sivaraju is a Family Practice in Verona, New Jersey. Qualified in 1997, 29 years ago. Practices with Vanguard Medical Group PA, a 60-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
29
Licensed in
NJ
In the registry since
2009

Practice location Address checks out

271 Grove Ave Ste A
Verona, NJ 07044-1731
Phone: (973) 239-2600
Fax: (833) 495-1921
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X · Licence 25MA08777500 (NJ)

Record details

NPI number1659508687
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 17, 2009
Last updated in NPPESApril 17, 2025
Certification dateApril 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesGERIATRIC MEDICINE, INTERNAL MEDICINE, OSTEOPATHIC MANIPULATIVE MEDICINE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Vanguard Medical Group Pa — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare