Active NPI
Opu M Rahman, PA
- Surgical Physician Assistant
- Bronx, NY
National Provider Identifier
1295176568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 016673
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1138 - Phone
- (718) 918-5000
- NPI assigned
- Jul 15, 2013
- Last updated
- Feb 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Surgical Physician Assistant | 363AS0400X | 016673 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Mailing address
3018 Barnes Ave
Apt. B
Bronx, NY 10467-8577
Phone (347) 503-9138
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2118 Williamsbridge Rd
Bronx, NY 10461-1602
Phone (718) 823-3900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016673 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelham Physical Medicine Inc | Current | Accepting new patients |
Locations
2118 Williamsbridge Rd
Bronx, NY 10461
Phone (718) 823-3900
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- orahman840993@nychhc.direct-ci.com
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.
-
- Specialist
- Bronx, NY
- NPI 1144262510
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Rehabilitation Clinic/Center
- Bronx, NY
- NPI 1952465338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1295176568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3018 BARNES AVE",
"address_2": "APT. B",
"city": "BRONX",
"state": "NY",
"postal_code": "104678577",
"telephone_number": "347-503-9138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-918-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHMAN",
"first_name": "OPU",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-15",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "016673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.