Irvington Primary Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IRVINGTON PRIMARY CARE LLC

Practice address

50 Union Ave
Suite 605
Irvington, NJ 07111-3262

Phone

(732) 388-2181

NPI assigned

Apr 24, 2013

Last updated

Feb 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tazzeen Ashraf

Title

President/Office Manager

Phone

(732) 388-2181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nudrat F Ayub, M.D

  • Internal Medicine Physician
  • Irvington, NJ
  • NPI 1346430774
  Medicare reassignment NPD
• Naila Khan, MD

  • Internal Medicine Physician
  • Richmond, TX
  • NPI 1386684876
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1134563836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MAIDA RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202530",
            "telephone_number": "732-388-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 UNION AVE",
            "address_2": "SUITE 605",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113262",
            "telephone_number": "732-388-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINGTON PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "ASHRAF",
        "authorized_official_first_name": "TAZZEEN",
        "authorized_official_title_or_position": "PRESIDENT/OFFICE MANAGER",
        "authorized_official_telephone_number": "732-388-2181"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irvington Home Health Care LLC
• Irvington Medical Imaging P.C.
• Irvington Pediatric Associates, P.a.
• Irvington Pharmacy LLC (Irvington Pharmacy)
• Irvington Physical Therapy
• Callista Ngozi Iwuala, APN-C
• Jennifer Iwudibia, PHARMD
• Vaishnavi Ravindran Iyer, BDS, MPH, DDS
• J's House
• Jackie Soul Catering LLC

• Clinic/Center in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (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.