Anjum Azam, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

231672 Issued in NY

Practice address

754 Lexington Ave
Brooklyn, NY 11221-2944

Phone

(201) 658-1722

Fax

(516) 812-6653

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (8 of 12)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: aazam47261@direct-chsli.net

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.

• Ahava Medical and Rehabilitation Center, LLC

  • Rehabilitation Practitioner
  • Brooklyn, NY
  • NPI 1184878274

  NY

  Medicare reassignment NPD
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1619245610

  NY

  Medicare reassignment NPD
• Dynamic Supplier Consultant Inc

  • Durable Medical Equipment & Medical Supplies
  • Valley Stream, NY
  • NPI 1033087804
  NPD Authorized official
• Valley Stream Medical Services PC

  • Psychiatry Physician
  • Valley Stream, NY
  • NPI 1629346283

  Psychiatry

  NPD (past) Authorized official
• Dynamic Technology Suppliers

  • Durable Medical Equipment & Medical Supplies
  • Valley Stream, NY
  • NPI 1689479347
  NPD
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1104097294
  NPD
• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1487698544
  NPD
• Downstate Mental Hygiene Associates

  • Public Health or Welfare Agency
  • Brooklyn, NY
  • NPI 1386678373
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285729699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SEATON PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801117",
            "telephone_number": "201-658-1722",
            "fax_number": "516-812-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 LEXINGTON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112212944",
            "telephone_number": "201-658-1722",
            "fax_number": "516-812-6653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 Seaton Pl",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115801117",
            "country_code": "US",
            "telephone_number": "201-658-1722",
            "fax_number": "516-812-6653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Sumner Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112064110",
            "country_code": "US",
            "telephone_number": "201-658-1722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Village Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115701000",
            "country_code": "US",
            "telephone_number": "516-705-2525",
            "fax_number": "516-812-6653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZAM",
        "first_name": "ANJUM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "231672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aza Home Health Care LLC
• Abul Azad, PA-C
• Tareq Azad, M.D.
• Maria Azaeva, FNP
• Ammara Azam
• Asma Azam
• Mariam Azam, MD
• Muhammad Umar Farooq Azam Sr.
• Tasmia Azam
• Batsheva Azar

• All providers in Brooklyn, NY
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.