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

Mrs. Renjini Raju Basil

Individual provider Family Nurse Practitioner · NPI 1790056182

Mrs. Renjini Raju Basil is a Nurse Practitioner in Bergenfield, New Jersey. Qualified in 1998, 28 years ago. Practices with Main Street Medical Providers LLC, a 5-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
28
Licensed in
NJ
In the registry since
2012

Practice location Address checks out

202 Howard Dr Apt # I
Bergenfield, NJ 07621
Phone: (201) 385-0538
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ00360600 (NJ)

Record details

NPI number1790056182
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 18, 2012
Last updated in NPPESJanuary 18, 2012

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Main Street Medical Providers Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bergenfield