Individual provider Active NPI

Ataur Rahman, M.D

  • Family Medicine Physician
  • South Daytona, FL
National Provider Identifier
1225045461
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME95010 Issued in FL
Practice address
905 Beville Rd
South Daytona, FL 32119-1705
Phone
(386) 767-9000
Fax
(386) 767-9000
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME95010 FL Primary

Addresses

Primary practice location

905 Beville Rd
South Daytona, FL 32119-1705

Mailing address

905 Beville Rd
South Daytona, FL 32119-1705
Phone (386) 767-9000

Other identifiers 1

IdentifierTypeStateIssuer
01876388MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME95010FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sarina Healthcare LLC Family Medicine PastSince Mar 21, 2021 Accepting new patients
Gohar S. Khan, M.D., P,a. Family Medicine PastSince Dec 4, 2011 Accepting new patients
Medical Resources, LLC Past Accepting new patients

Organizations & group practices 3

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1225045461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 BEVILLE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191705",
            "telephone_number": "386-767-9000",
            "fax_number": "386-767-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 BEVILLE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191705",
            "telephone_number": "386-767-9000",
            "fax_number": "386-767-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "ATAUR",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01876388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.