Individual provider Active NPI

Cyrus Vosough, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wayne, NJ
National Provider Identifier
1194729475
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
MA070629 Issued in NJ
Practice address
504 Hamburg Tpke Ste B105
Wayne, NJ 07470-2011
Phone
(973) 595-0063
Fax
(973) 240-8990
NPI assigned
Jun 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X MA070629 NJ Primary

Addresses

Primary practice location

504 Hamburg Tpke Ste B105
Wayne, NJ 07470-2011

Mailing address

PO Box 43092
Upper Montclair, NJ 07043-0092
Phone (973) 595-0063

Other identifiers 1

IdentifierTypeStateIssuer
8481008MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000040 NJ Practitioner - Physical Medicine and Rehabilitation 5395710446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers, Robert Woood Johnson Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Medical, LLCGroup PAC ID 8628015195, 2 clinicians

Practice addresses (Care Compare)

2182 Morris Ave
Union, NJ 07083-5902
Phone (908) 851-2666

504 Hamburg Tpke
Suite B105
Wayne, NJ 07470-2034
Phone (973) 595-0063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA070629NJMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Medical, LLC CurrentSince Jun 17, 2024 Accepting new patients
North Jersey Rehab LLC CurrentSince Sep 1, 2003 Accepting new patients

Locations

1900 Union Valley Rd
Hewitt, NJ 07421
Phone (973) 248-0200

2182 Morris Ave
Union, NJ 07083
Phone (908) 851-2666

510 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (973) 720-8333

504 Hamburg Tpke
Ste B105
Wayne, NJ 07470
Phone (973) 595-0063

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1194729475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43092",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070430092",
            "telephone_number": "973-595-0063",
            "fax_number": "973-720-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 HAMBURG TPKE STE B105",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702011",
            "telephone_number": "973-595-0063",
            "fax_number": "973-240-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOSOUGH",
        "first_name": "CYRUS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "MA070629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8481008",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.