Organization Active NPI

Abbasi Medical Group LLC

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1194151019
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05862000 Issued in NJ
Legal business name
ABBASI MEDICAL GROUP LLC
Practice address
1300 Main Ave Apt 2D
Clifton, NJ 07011-2266
Phone
(973) 851-7818
Fax
(201) 595-0290
NPI assigned
Sep 24, 2013
Last updated
Sep 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Authorized official

Name
Dr. Tareef Abbasi, MDNPI 1427139617
Title
Doctor/Owner
Phone
(201) 766-1541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA05862000 NJ Primary

Addresses

Primary practice location

1300 Main Ave Apt 2D
Clifton, NJ 07011-2266

Mailing address

57 Bensam PL
North Haledon, NJ 07508-3068
Phone (201) 766-1541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131105000324 NJ Part B Supplier - Clinic/Group Practice 4789819426 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1194151019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BENSAM PL",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075083068",
            "telephone_number": "201-766-1541",
            "fax_number": "201-595-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MAIN AVE APT 2D",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112266",
            "telephone_number": "973-851-7818",
            "fax_number": "201-595-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBASI MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "ABBASI",
        "authorized_official_first_name": "TAREEF",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "201-766-1541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05862000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.