Individual provider Active NPI

Opu M Rahman, PA

  • Surgical Physician Assistant
  • Bronx, NY
National Provider Identifier
1295176568
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
016673 Issued in NY
Practice address
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone
(718) 918-5000
NPI assigned
Jul 15, 2013
Last updated
Feb 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170301000791 NY Practitioner - Physician Assistant 5698059194 Reassigns benefits to 2 organizations

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
Pelham Physical Medicine IncGroup PAC ID 8325939093, 4 clinicians

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

LicenseStateTypeSpecialty
016673NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelham Physical Medicine Inc CurrentSince Jan 25, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.