Individual provider Active NPI

Firoz Pushkin Rahman, MD

  • Psychiatry Physician
  • Princeton, NJ
National Provider Identifier
1053351080
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA07077500 Issued in NJ
Practice address
905 Herrontown Rd
Princeton, NJ 08540-1901
Phone
(814) 366-1315
NPI assigned
Jun 7, 2006
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA07077500 NJ Primary
Psychiatry Physician 2084P0800X MD069488L PA

Addresses

Primary practice location

905 Herrontown Rd
Princeton, NJ 08540-1901

Mailing address

905 Herrontown Rd
Princeton, NJ 08540-1901
Phone (814) 366-1315

Other practice location 1

4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322
Phone (609) 482-3701

Other identifiers 1

IdentifierTypeStateIssuer
0018187000009MedicaidPA

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
I20090813000384 NJ Practitioner - Psychiatry 9830121508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton House Provider Group LLCGroup PAC ID 0244540540, 45 clinicians

Practice addresses (Care Compare)

905 Herrontown Rd
Princeton, NJ 08540-1901
Phone (609) 497-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07077500NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC Current Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jan 31, 2010 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jan 31, 2010 Accepting new patients
Princeton House Provider Group LLC Psychiatry CurrentSince Sep 1, 2015 Accepting new patients
Bradford Regional Medical Services Psychiatry Past Accepting new patients
Alcohol & Drug Abuse Services, Inc Past Accepting new patients
Olean General Hospital Past Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

11 Centre Dr
Ste A
Monroe Twp, NJ 08831
Phone (609) 395-2462

1460 Livingston Ave
Bldg 100
North Brunswick, NJ 08902
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540
Phone (609) 497-3300

1 Washington Blvd
Ste A
Trenton, NJ 08691
Phone (609) 448-4353

300 Clocktower Dr
Ste 101
Trenton, NJ 08690
Phone (609) 688-2788

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1053351080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 HERRONTOWN RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401901",
            "telephone_number": "814-366-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HERRONTOWN RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401901",
            "telephone_number": "814-366-1315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Princess Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "NJ",
            "postal_code": "086482322",
            "country_code": "US",
            "telephone_number": "609-482-3701",
            "fax_number": "609-482-3702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "FIROZ",
        "middle_name": "PUSHKIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07077500",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD069488L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018187000009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.