Premiere Nephrology and Hypertension LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA064906 Issued in NJ

Legal business name

PREMIERE NEPHROLOGY AND HYPERTENSION LLC

Practice address

240 Williamson St
Suite 405
Elizabeth, NJ 07202-3674

Phone

(908) 353-2064

NPI assigned

Apr 16, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Maria Lourdes Silva-Khazaei, MDNPI 1588646400

Title

Owner

Phone

(908) 353-2064

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Lourders Silva-Khazaei, M.D

  • Specialist
  • Linden, NJ
  • NPI 1588646400
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1154764595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 405",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-353-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 405",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-353-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE NEPHROLOGY AND HYPERTENSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "SILVA-KHAZAEI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LOURDES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-353-2064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA064906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8761302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.