Individual provider Active NPI

Owen R. Rahman, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Newark, NJ
National Provider Identifier
1104970920
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MA04395400 Issued in NJ
Practice address
30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Phone
(973) 972-0037
Fax
(973) 972-9355
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA04395400 NJ Primary

Addresses

Primary practice location

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Phone (973) 972-0037

Other identifiers 1

IdentifierTypeStateIssuer
8631000MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071105000367 FL Practitioner - Anesthesiology 6608867668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Temple University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

12961 Palm W Dr
Loxahatchee, FL 33470-4989
Phone (561) 793-0437

13001 Southern Blvd
Loxahatchee, FL 33470-9203
Phone (561) 798-3300

Hospital & facility affiliations

  • HCA Florida Palms West Hospital Hospital, Loxahatchee, FL, CCN 100269

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04395400NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc CurrentSince Sep 10, 2007 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 10, 2007 Accepting new patients
Sheridan Anesthesia Services of New Jersey PC Past Accepting new patients

Locations

12961 Palms West Dr
Loxahatchee, FL 33470
Phone (561) 793-0437

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 4

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 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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1104970920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-0037",
            "fax_number": "973-972-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-0037",
            "fax_number": "973-972-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "OWEN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA04395400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8631000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.