Individual provider Active NPI

Rosaline A Ahkami, MD

  • Dermatology Physician
  • Warren, NJ
National Provider Identifier
1265449334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MA064016 Issued in NJ
Practice address
122 Mt Bethel Rd Ste 1
Warren Dermatology Associates LLC
Warren, NJ 07059
Phone
(908) 756-7999
Fax
(908) 756-8017
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MA064016 NJ Primary

Addresses

Primary practice location

122 Mt Bethel Rd Ste 1
Warren Dermatology Associates LLC
Warren, NJ 07059

Mailing address

55 Churchill Dr
Clifton, NJ 07103
Phone (973) 471-1989

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
I20101004000266 NJ Practitioner - Dermatology 5698967156 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA064016NJMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Dermatology Associates, LLC Dermatology CurrentSince Jan 1, 2013 Accepting new patients

Locations

1031 McBride Ave
Ste D203
Woodland Park, NJ 07424
Phone (973) 256-6350

Interoperability endpoints

  • Direct secure messaging: rahkami@directaddress.net

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers New Jersey Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Dermatology Associates, LLC 2 clinicians

Practice addresses (Care Compare)

1031 McBride Ave
D203
Woodland Park, NJ 07424-2569
Phone (973) 256-6350

1031 McBride Aveune
Suite D203
Woodland Park, NJ 07424-2569

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions23

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265449334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CHURCHILL DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-471-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MT BETHEL RD STE 1",
            "address_2": "WARREN DERMATOLOGY ASSOCIATES LLC",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "07059",
            "telephone_number": "908-756-7999",
            "fax_number": "908-756-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHKAMI",
        "first_name": "ROSALINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA064016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

Verify at the official NPI Registry.