Individual provider Active NPI

Nadiyah Rahaman, APRN

  • Pediatric Nurse Practitioner
  • Union, NJ
National Provider Identifier
1306467014
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ14868500 Issued in NJ
Practice address
2840 Morris Ave
Union, NJ 07083-4851
Phone
(882) 445-3738
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 757715 NY
Nurse Practitioner 363L00000X 9019 CT
Pediatric Nurse Practitioner 363LP0200X 26NJ14868500 NJ Primary

Addresses

Primary practice location

2840 Morris Ave
Union, NJ 07083-4851

Mailing address

2840 Morris Ave
Union, NJ 07083-4851
Phone (888) 244-5373

Other practice location 1

76 New Britain Ave
Hartford, CT 06106-3305
Phone (860) 547-0970

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626001693 NJ Practitioner - Nurse Practitioner 3476972415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

379 Campus Dr
Somerset, NJ 08873-1161

66 W Gilbert St
Tinton Falls, NJ 07701-4947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
757715NYMDRegistered Nurse
9019CTMDNurse Practitioner
26NJ14868500NJMDPediatric Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1306467014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834851",
            "telephone_number": "888-244-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834851",
            "telephone_number": "882-445-3738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 New Britain Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063305",
            "country_code": "US",
            "telephone_number": "860-547-0970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHAMAN",
        "first_name": "NADIYAH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "757715",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "9019",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ14868500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.