Individual provider Active NPI

Ahmad Bassem Nashif, PA

  • Medical Physician Assistant
  • Lawrenceville, NJ
National Provider Identifier
1053879379
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00515900 Issued in NJ
Practice address
4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322
Phone
(609) 482-3701
NPI assigned
Mar 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00515900 NJ Primary

Addresses

Primary practice location

4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322

Mailing address

5 Brianna CT
Hamilton, NJ 08619-1400
Phone (609) 789-7385

Other practice location 1

1760 Whitehorse Hamilton Square Rd Ste 1
Hamilton, NJ 08690-3535
Phone (609) 890-8200

Other practice location 2

14 Ridgedale Ave
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529002130 NJ Practitioner - Physician Assistant 6709129018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Memory and Behavioral CareGroup PAC ID 7719013267, 71 clinicians

Practice addresses (Care Compare)

14 Ridgedale Ave
Suite 103
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335

575 Route 28
Suite 2108
Raritan, NJ 08869-1354
Phone (973) 295-6335

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00515900NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Medical Services LLC PastSince May 31, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1053879379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRIANNA CT",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191400",
            "telephone_number": "609-789-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD STE 206",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "609-482-3701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 Whitehorse Hamilton Square Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "NJ",
            "postal_code": "086903535",
            "country_code": "US",
            "telephone_number": "609-890-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Ridgedale Ave",
            "address_purpose": "LOCATION",
            "city": "Cedar Knolls",
            "state": "NJ",
            "postal_code": "079271106",
            "country_code": "US",
            "telephone_number": "973-295-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASHIF",
        "first_name": "AHMAD",
        "middle_name": "BASSEM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-05",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00515900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.