Individual provider Active NPI

Samia Riaz Chaudry, D.O.

  • Family Medicine Physician
  • Fair Lawn, NJ
National Provider Identifier
1366604605
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB08847900 Issued in NJ
Practice address
41 04 Goldblatt Terrace
Fair Lawn, NJ 07410-5911
Phone
(201) 797-7129
Fax
(201) 703-6982
NPI assigned
Jun 27, 2008
Last updated
Jan 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB08847900 NJ Primary

Addresses

Primary practice location

41 04 Goldblatt Terrace
Fair Lawn, NJ 07410-5911

Mailing address

41-04 Goldblatt Ter
Fair Lawn, NJ 07410-5911
Phone (201) 797-7129

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000232 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6800068834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

41 -04 Goldblatt Ter
Fair Lawn, NJ 07410-5911
Phone (201) 797-7129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
277474NYMDLicensed Practical Nurse
25MB08847900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samia R. Chaudry DO LLC Family Medicine CurrentSince Sep 16, 2011 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1366604605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-04 GOLDBLATT TER",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105911",
            "telephone_number": "201-797-7129",
            "fax_number": "201-703-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 04 GOLDBLATT TERRACE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105911",
            "telephone_number": "201-797-7129",
            "fax_number": "201-703-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDRY",
        "first_name": "SAMIA",
        "middle_name": "RIAZ",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08847900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.