Active NPI
Mohammad Rafic Al-Ajam, MD
- Pulmonary Disease Physician
- Brooklyn, NY
National Provider Identifier
1487764924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD436001
- Practice address
- 800 Poly PL
Pulmonary Division RM 13-105
Brooklyn, NY 11209-7104 - Phone
- (718) 836-6600
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD436001 | PA | |
| Pulmonary Disease Physician | 207RP1001X | MD436001 | PA | Primary |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | MD436001 | PA |
Addresses
Primary practice location
800 Poly PL
Pulmonary Division RM 13-105
Brooklyn, NY 11209-7104
Mailing address
800 Poly Place
Brooklyn, NY 11209
Phone (718) 630-3722
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD436001 | Other | PA | LICENSE |
| 270260 | Other | NY | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD436001 | PA | MD | Critical Care Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1487764924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POLY PLACE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11209",
"telephone_number": "718-630-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"address_2": "PULMONARY DIVISION RM 13-105",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "718-836-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-AJAM",
"first_name": "MOHAMMAD",
"middle_name": "RAFIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "PA",
"license": "MD436001",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "PA",
"license": "MD436001",
"primary": true
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "PA",
"license": "MD436001",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "MD436001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "270260",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.