NPIMap

Organization Active NPI

Regional Neurological Associates, PC

  • Specialist
  • Bronx, NY
National Provider Identifier
1306800057
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
195905 Issued in NY
Legal business name
REGIONAL NEUROLOGICAL ASSOCIATES, PC
Practice address
4234 Bronx Blvd FRNT 1
Bronx, NY 10466-2669
Phone
(718) 515-4347
Fax
(718) 653-8641
NPI assigned
Apr 12, 2006
Last updated
Feb 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Kamran Tabaddor, MD
Title
President
Phone
(718) 655-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 195905 NY Primary

Addresses

Primary practice location

4234 Bronx Blvd FRNT 1
Bronx, NY 10466-2669

Mailing address

4234-1 Bronx Boulevard
Bronx, NY 10466-2801
Phone (718) 515-4347

Other identifiers 9

IdentifierTypeStateIssuer
01638462MedicaidNY
0H1338OtherNYHEALTHNET
9603726003OtherNYCIGNA
RB0476N110OtherNYBLUE CROSS BLUE SHIELD
195905OtherNYHIP
10599OtherNYHIP CMO
1279657OtherNYUNITED HEALTHCARE
231955OtherNYMANGED HEALTHNET
P623258OtherNYOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060109000291 NY Part B Supplier - Clinic/Group Practice 6709809452 Receives reassigned benefits from 15 practitioners
Practice locations: Bronx, NY; Yonkers, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

4256 Bronx Blvd
Ste 5
Bronx, NY 10466
Phone (718) 655-9111

820 2nd Ave
Rm 6C
New York, NY 10017
Phone (212) 537-9272

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1306800057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234-1 BRONX BOULEVARD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662801",
            "telephone_number": "718-515-4347",
            "fax_number": "718-653-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 BRONX BLVD FRNT 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662669",
            "telephone_number": "718-515-4347",
            "fax_number": "718-653-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL NEUROLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "TABADDOR",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-655-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "195905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01638462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0H1338",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9603726003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "RB0476N110",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "195905",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP CMO",
            "identifier": "10599",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1279657",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANGED HEALTHNET",
            "identifier": "231955",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P623258",
            "state": "NY"
        }
    ],
    "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 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.