Aysha Azam, DO – Family Medicine Physician

Key facts

NPI: 1114508108
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 25MB12053000 (NJ)
Practice address: 110 Rehill Ave
Somerville, NJ 08876-2519
Phone: (908) 685-2200
Fax: (732) 923-2272
NPI assigned: Apr 20, 2021
Sex: Female
Sole proprietor: No

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.

Rwjbh Primary Care Services Internal Medicine Physician · West Orange, NJ · NPI 1265037501

Medicare reassignment Care Compare group NPD FAMILY MEDICINE · NJ
Robert Wood Johnson University Hospital Inc General Acute Care Hospital · Somerville, NJ · NPI 1003236878

NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Robert Wood Johnson University Hospital Inc General Acute Care Hospital · Somerville, NJ · NPI 1003236878

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Philadelphia College of Osteopathic Medicine, 2021
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Rwjbh Primary Care Services (266 clinicians)

Practice addresses (Care Compare)

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2900

Hospital & facility affiliations

Robert Wood Johnson University Hospital - Somerset Hospital · Somerville, NJ · CCN 310048

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NJ
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240509003364	NJ	Practitioner - Family Practice	3375984222	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Rwjbh Primary Care Services	Family Medicine	Current since Jun 1, 2024	Accepting new patients
Robert Wood Johnson University Hospital Inc		Past	Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Interoperability endpoints

FHIR API: https://fhir-myrecord.cerner.com/r4/xYxhuXIFsLg59PaSNJv_x-piAtPKX3W8/

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	25MB12053000	NJ	Yes

Addresses

Primary practice location

110 Rehill Ave
Somerville, NJ 08876-2519

Mailing address

379 Campus Dr FL 4
Somerset, NJ 08873-1161
Phone (732) 937-8939

Other providers in Somerville, NJ

All providers in Somerville, NJ · Family Medicine Physician in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.