Active NPI
Bruce Nadjmi
- Urology Physician
- Lincoln, RI
National Provider Identifier
1104075084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD04790
- Practice address
- 5 Christopher Drive
Lincoln, RI 02865-4946 - Phone
- (401) 723-7216
- Fax
- (401) 723-7216
- NPI assigned
- Sep 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD04790 | RI | Primary |
Addresses
Primary practice location
5 Christopher Drive
Lincoln, RI 02865-4946
Mailing address
5 Christopher Drive
Lincoln, RI 02865-4946
Phone (401) 723-7216
Other names 1
- Borzoo Johan Nadjmi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD04790 | RI | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1104075084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 CHRISTOPHER DRIVE",
"city": "LINCOLN",
"state": "RI",
"postal_code": "028654946",
"telephone_number": "401-723-7216",
"fax_number": "401-723-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CHRISTOPHER DRIVE",
"city": "LINCOLN",
"state": "RI",
"postal_code": "028654946",
"telephone_number": "401-723-7216",
"fax_number": "401-723-7216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADJMI",
"first_name": "BRUCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "RI",
"license": "MD04790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BORZOO",
"last_name": "NADJMI",
"middle_name": "JOHAN",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lincoln, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.