Individual provider Active NPI

Jihad S Moukdad

  • Internal Medicine Physician
  • Secaucus, NJ
National Provider Identifier
1235221094
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06106900 Issued in NJ
Practice address
1265 Paterson Plank Rd
Secaucus, NJ 07094-3242
Phone
(201) 223-1121
Fax
(201) 223-1126
NPI assigned
Sep 29, 2006
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06106900 NJ Primary

Addresses

Primary practice location

1265 Paterson Plank Rd
Secaucus, NJ 07094-3242

Mailing address

1265 Paterson Plank Rd
Secaucus, NJ 07094-3242

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
I20040415000661 NJ Practitioner - Internal Medicine 0042205577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1265 Paterson Plank Rd
3B
Secaucus, NJ 07094-3242
Phone (201) 223-1121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moukdad Medical LLC Internal Medicine Current Accepting new patients
J S Moukdad MD LLC Internal Medicine CurrentSince Jun 19, 2004 Accepting new patients
Njmhmc, LLC Past Accepting new patients

Locations

1265 Paterson Plank Rd
Ste 3B
Secaucus, NJ 07094
Phone (201) 223-1121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1235221094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 PATERSON PLANK RD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 PATERSON PLANK RD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943242",
            "telephone_number": "201-223-1121",
            "fax_number": "201-223-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUKDAD",
        "first_name": "JIHAD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06106900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.