Idrees Ahmad, M.D.
Individual provider Active NPI Pain Medicine (Anesthesiology) Physician · Millburn, NJ
NPI 1164533527 · NPPES record last updated Mar 26, 2009
Key facts
- NPI
- 1164533527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pain Medicine (Anesthesiology) Physician 207LP2900X
- License
- 25MA04153300 (NJ)
- Practice address
- 187 Millburn Ave
Millburn, NJ 07041-1847 - Phone
- (973) 467-1466
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New Jersey Healthcare Specialists PC
Practice addresses (Care Compare)
187 Millburn Ave
Millburn, NJ 07041-1847
Phone (973) 671-0555
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 |
|---|---|---|---|---|
| I20050217000620 | NJ | Practitioner - Anesthesiology | 3577515535 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04153300 | NJ | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Healthcare Specialists PC | Anesthesiology | Current |
Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
187 Millburn Ave
Millburn, NJ 07041
Phone (973) 467-1466
187 Millburn Ave
Ste 102
Millburn, NJ 07041
Phone (973) 671-0555
187 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (212) 226-2066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA04153300 | NJ | |
| Pain Medicine Physician | 208VP0000X | 25MA04153300 | NJ | |
| Interventional Pain Medicine Physician | 208VP0014X | 25MA04153300 | NJ | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 25MA04153300 | NJ | Yes |
Addresses
Primary practice location
187 Millburn Ave
Millburn, NJ 07041-1847
Mailing address
187 Millburn Ave
Millburn, NJ 07041-1847
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430340TZG | Other | NJ | MEDICARE |
| 4969103 | Medicaid | NJ |
Other providers in Millburn, NJ
- Yetunde Adeola
- Advanced Ambulatory Anesthesiologists LLC
- Advanced Comprehensive Laboratory
- Advanced Therapeutic Center LLC
- Agape Touch LLC Dba Preferred Care at Home of Northeast New Jersey
- Andrea Alexander
- Dominick Algeri
- All Care Pediatrics PA
- Allprohealth
- Alta Orthopedics PC
All providers in Millburn, NJ · Pain Medicine (Anesthesiology) 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 Mar 26, 2009. 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.