Individual provider Active NPI

Sanjay Ahlawat

  • Psychiatric/Mental Health Nurse Practitioner
  • Old Bridge, NJ
National Provider Identifier
1245485895
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00663700 Issued in NJ
Practice address
42 Throckmorton LN
Old Bridge, NJ 08857-2572
Phone
(732) 607-1111
Fax
(732) 607-0552
NPI assigned
Nov 24, 2008
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00663700 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00663700 NJ Primary

Addresses

Primary practice location

42 Throckmorton LN
Old Bridge, NJ 08857-2572

Mailing address

9 Aspen Rd
West Orange, NJ 07052-1201
Phone (862) 216-4879

Other practice location 1

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 518-5000

Other practice location 2

741 Broadway
Newark, NJ 07104
Phone (201) 675-1900

Other names 1

  • Dr. Sanjay Ahlawat Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516001863 NJ Practitioner - Nurse Practitioner 4688917594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gold Standard Medical Group PCGroup PAC ID 2961762554, 32 clinicians

Practice addresses (Care Compare)

992 Clifton Ave
Clifton, NJ 07013-3502
Phone (201) 839-5016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00663700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Standard Medical Group PC Multi-Specialty CurrentSince May 15, 2025 Accepting new patients
Newark Community Health Centers, Inc CurrentSince May 27, 2019 Accepting new patients
Newark Community Health Centers, Inc. Multi-Specialty CurrentSince May 27, 2019 Accepting new patients

Locations

992 Clifton Ave
Clifton, NJ 07013
Phone (201) 839-5016

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1245485895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ASPEN RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521201",
            "telephone_number": "862-216-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 THROCKMORTON LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572572",
            "telephone_number": "732-607-1111",
            "fax_number": "732-607-0552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577606",
            "country_code": "US",
            "telephone_number": "718-518-5000",
            "fax_number": "718-518-5124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "741 Broadway",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "07104",
            "country_code": "US",
            "telephone_number": "201-675-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHLAWAT",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00663700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00663700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANJAY",
            "last_name": "AHLAWAT",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.