Individual provider Active NPI

Thomas Aghahowa Imahiyerobo Jr., M.D.

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
National Provider Identifier
1144473117
Registry record updated May 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
267233 Issued in NY
Practice address
177 Fort Washington Ave
MHB-7-313
New York, NY 10032-3733
Phone
(212) 305-3038
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 267233 NY Primary

Addresses

Primary practice location

177 Fort Washington Ave
MHB-7-313
New York, NY 10032-3733

Mailing address

161 Fort Washington Ave
Suite 511a
New York, NY 10032-3729
Phone (212) 305-9612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20150623000486 NY Practitioner - Plastic and Reconstructive Surgery 2860611027 Reassigns benefits to 2 organizations
I20240826003113 NJ Practitioner - Plastic and Reconstructive Surgery 2860611027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Harvard Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Grand Ave
Suite 1
Englewood, NJ 07631-4968
Phone (212) 342-8586

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130481CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 14, 2024 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 14, 2024 Accepting new patients
The Trustees of Columbia University in the City of New York Plastic and Reconstructive Surgery CurrentSince Jun 1, 2015 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

400 Kelby St
Ste 11
Fort Lee, NJ 07024

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

300 Frank W Burr Blvd
Ste 130
Teaneck, NJ 07666
Phone (212) 305-6936

1 Pondfield Rd
Bronxville, NY 10708
Phone (914) 337-5956

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

3959 Broadway
Fl 5
New York, NY 10032
Phone (212) 305-8933

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
Ste 511A
New York, NY 10032
Phone (212) 342-3704

161 Fort Washington Ave
Fl 5
New York, NY 10032
Phone (212) 305-4000

161 Fort Washington Ave
#5
New York, NY 10032
Phone (212) 342-4743

177 Fort Washington Ave
#7313
New York, NY 10032
Phone (212) 305-3038

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tai9007@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

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 5

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431129600000",
    "number": "1144473117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "address_2": "SUITE 511A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-9612",
            "fax_number": "212-305-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "address_2": "MHB-7-313",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-305-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAHIYEROBO",
        "first_name": "THOMAS",
        "middle_name": "AGHAHOWA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2015-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "267233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.