Ilyas Ahmed, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA04681100 Issued in NJ

Practice address

217 Laurel Heights Drive
Bridgeton, NJ 08302-3635

Phone

(856) 451-4150

Fax

(856) 451-2645

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

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.

• Excelcare Alliance, LLC

  • Family Medicine Physician
  • Vineland, NJ
  • NPI 1891090510

  Internal Medicine, NJ

  Medicare reassignment NPD
• South Jersey Hearing and Tinnitus, LLC

  • Audiologist
  • Bridgeton, NJ
  • NPI 1386477842
  NPD
• Bellevue Garden Group, LLC

  • Skilled Nursing Facility
  • Trenton, NJ
  • NPI 1689322489
  NPD (past)
• Dendrinos Medical Associates, P.a.

  • General Practice Physician
  • Vineland, NJ
  • NPI 1386839603
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1497761589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 LAUREL HEIGHTS DRIVE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023635",
            "telephone_number": "856-451-4150",
            "fax_number": "856-451-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 LAUREL HEIGHTS DRIVE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023635",
            "telephone_number": "856-451-4150",
            "fax_number": "856-451-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "ILYAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04681100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P505320",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4089916",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409805",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0274853001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1450 Associates, LLC
• 4977, LLC
• ABA Changing Behaviors
• Moby Abraham
• Alan I Gurwood
• Yazen Waleed Almousa, DDS
• Kelly F Amato, LCSW
• Vinod Gopaldas Anandpara, M.D.
• Michelle Andrews, LPN

• All providers in Bridgeton, NJ
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.