Individual provider Active NPI

Razwana Wahdat, D.O.

  • Emergency Medicine Physician
  • Stratford, NJ
National Provider Identifier
1104238856
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB10259900 Issued in NJ
Practice address
18 E Laurel Rd
Stratford, NJ 08084-1327
Phone
(856) 346-7985
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10259900 NJ Primary

Addresses

Primary practice location

18 E Laurel Rd
Stratford, NJ 08084-1327

Mailing address

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 346-7985

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
I20180523003206 NJ Practitioner - Emergency Medicine 7719242601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians

Practice addresses (Care Compare)

1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (908) 522-2232

Hospital & facility affiliations

  • Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10259900NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

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.

Hospital & facility affiliations 2

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1104238856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-346-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-346-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHDAT",
        "first_name": "RAZWANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10259900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.