Individual provider Active NPI

Ashraf Faltas

  • Internal Medicine Physician
  • Cliffside Park, NJ
National Provider Identifier
1275635070
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07315400 Issued in NJ
Practice address
596 Anderson Ave
Suite 201
Cliffside Park, NJ 07010-1831
Phone
(201) 313-3222
Fax
(201) 313-3220
NPI assigned
Sep 2, 2006
Last updated
Sep 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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 25MA07315400 NJ Primary

Addresses

Primary practice location

596 Anderson Ave
Suite 201
Cliffside Park, NJ 07010-1831

Mailing address

596 Anderson Ave
Suite 201
Cliffside Park, NJ 07010-1831
Phone (201) 313-3222

Other identifiers 1

IdentifierTypeStateIssuer
8672008MedicaidNJ

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
I20051221000326 NJ Practitioner - Internal Medicine 5698797595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1704 John F Kennedy Blvd
Jersey City, NJ 07305-1862
Phone (201) 413-9400

596 Anderson Ave
Suite 201
Cliffside Park, NJ 07010-1856

596 Anderson Ave
Suite 201
Cliffside Park, NJ 07010-1872
Phone (201) 313-3222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07315400NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashraf Faltas Internal Medicine CurrentSince Dec 1, 2005 Accepting new patients
Haro Podiatry Center PC Past Accepting new patients
Ghias Moussa MD Past Accepting new patients

Locations

596 Anderson Ave
Ste 201
Cliffside Pk, NJ 07010
Phone (201) 313-3222

Interoperability endpoints

  • Direct secure messaging: afaltas45714@epicdirect.rwjbh.org

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1275635070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 201",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-313-3222",
            "fax_number": "201-313-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE 201",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101831",
            "telephone_number": "201-313-3222",
            "fax_number": "201-313-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALTAS",
        "first_name": "ASHRAF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07315400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8672008",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

Verify at the official NPI Registry.