Individual provider Active NPI

Ahad Anjum, DO

  • Emergency Medicine Physician
  • Staten Island, NY
National Provider Identifier
1114423498
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C2-0024598 Issued in DE
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9000
NPI assigned
Apr 4, 2018
Last updated
Nov 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 75488 CT
Emergency Medicine Physician 207P00000X 310237 NY
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X C2-0024598 DE Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210723000938 NY Practitioner - Emergency Medicine 4284037532 Reassigns benefits to 1 organization
I20241204001065 DE Practitioner - Emergency Medicine 4284037532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Emergency Physicians LLCGroup PAC ID 7719240696, 80 clinicians

Practice addresses (Care Compare)

640 S State St
Bayhealth Emergency Physicians KGH
Dover, DE 19901-3530
Phone (302) 744-6156

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as group
Quality
78.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 3, 2023 Accepting new patients
Danbury Hospital Current Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Jul 3, 2023 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

18383 Hudson Rd
Ste B
Milton, DE 19968
Phone (302) 725-3499

401 N Carter Rd
Ste 101
Smyrna, DE 19977
Phone (302) 659-2190

401 N Carter Rd
Smyrna, DE 19977
Phone (302) 653-2010

300 Community Dr
Manhasset, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1114423498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANJUM",
        "first_name": "AHAD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "75488",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "310237",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C2-0024598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.