Individual provider Active NPI

Tahirah Abdur Rahman, DO

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1477843316
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
008588 Issued in AZ
Practice address
4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231
Phone
(480) 882-4545
Fax
(602) 381-1341
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS017153 PA
Internal Medicine Physician 207R00000X 34.011577 OH
Internal Medicine Physician 207R00000X 008588 AZ Primary

Addresses

Primary practice location

4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Other identifiers 1

IdentifierTypeStateIssuer
081469MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20201021000963 AZ Practitioner - Internal Medicine 5193048528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20440 N 27TH Ave
Phoenix, AZ 85027-3240
Phone (480) 882-4545

4131 N 24TH St
Phoenix, AZ 85016-6231
Phone (480) 882-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.011577OHMDInternal Medicine Physician
OS017153PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health CurrentSince Oct 10, 2022 Accepting new patients
Neighborhood Outreach Access to Health Family Medicine CurrentSince Oct 10, 2022 Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

16251 N Cave Creek Rd
Phoenix, AZ 85032

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

9015 N 3rd St
Phoenix, AZ 85020

20440 N 27th Ave
Phoenix, AZ 85027

8705 E McDowell Rd
Scottsdale, AZ 85257

Interoperability endpoints

  • Direct secure messaging: tahirah.abdurrahman.p1@direct.nachci.nextgenshare.com
  • Direct secure messaging: tabdurrahman607855@direct.ochin.org

Organizations & group practices 2

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": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1477843316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 N 24TH ST STE B102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166231",
            "telephone_number": "480-882-4545",
            "fax_number": "602-381-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDUR RAHMAN",
        "first_name": "TAHIRAH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS017153",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.011577",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "008588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081469",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.