Asim Makhdom, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD456673 Issued in PA

Practice address

195 Pleasant Street, Suite 5
Bradford, PA 16701

Phone

(814) 362-5701

Fax

(814) 362-5702

NPI assigned

Sep 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1043767734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "741-669-2330",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 PLEASANT STREET, SUITE 5",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "16701",
            "telephone_number": "814-362-5701",
            "fax_number": "814-362-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHDOM",
        "first_name": "ASIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-09",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "287870",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD456673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04760550",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Elizabeth Lobdell, PHARMD
• Banafsheh Lotfi Moghaddas, M.D.
• Luis C Gonzalez MD
• Lynn Lunn
• Alliyson Marie Maduri, M.S., SLP-CCC/L
• James Mancini, DDS
• Maraposa Surgical Inc.
• Maria Fisher Enix
• Nicole Marker-Zewe, CRNP
• Jeana Marquez

• Orthopaedic Surgery Physician in Bradford, PA
• Providers in Bradford, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.