Ambreen Raza, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

25MA11143400 Issued in NJ

Practice address

804 S Dupont Blvd
Milford, DE 19963-1757

Phone

(302) 430-0867

NPI assigned

Sep 14, 2012

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious Disease

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kennedy Medical Group Practice, P.C.

  dba Jefferson Health

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Kennedy Medical Group Practice PC

  dba Kennedy Health Alliance

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD
• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1427350040
  NPD
• Kennedy Medical Group Practice P.C.

  dba Kennedy Health Alliance

  • Family Medicine Physician
  • West Deptford, NJ
  • NPI 1952615981
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1326398579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET, POB 3RD FLOOR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631757",
            "telephone_number": "302-430-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "AMBREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0012085",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA11143400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Nicole Puddicombe, DMD
• Pure Wellness of Milford, LLC
• Kelsey Ann Queen, M.S., BCBA
• Rabail Qureshi, M.D
• Keren Rams-Harmon
• Amanda Reed, P.T.A.
• Reliable Health & Rehab, LLC
• John Clifford Renyo, D.C.
• Marie Renzi, FNP-BC
• Jonathan Revels, MS, LCDP, LPCMH

• Infectious Disease Physician in Milford, DE
• Providers in Milford, DE by specialty
• Infectious Disease Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.

Verify at the official NPI Registry.