Individual provider Active NPI

Timur Ruzehaji, NP

  • Adult Health Nurse Practitioner
  • Dix Hills, NY
National Provider Identifier
1508643412
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ14946600 Issued in NJ
Practice address
4 Dix Cir
Dix Hills, NY 11746-6001
Phone
(201) 562-2464
NPI assigned
Sep 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311321 NY
Adult Health Nurse Practitioner 363LA2200X 26NJ14946600 NJ Primary

Addresses

Primary practice location

4 Dix Cir
Dix Hills, NY 11746-6001

Mailing address

4 Dix Cir
Dix Hills, NY 11746-6001
Phone (201) 562-2464

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404002431 NJ Practitioner - Nurse Practitioner 7810335247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

276 Passaic Ave
Unit a
Kearny, NJ 07032-1129
Phone (201) 719-9371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311321NYMDOphthalmology Physician
26NJ14946600NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Radiology Group of New Jersey, LLC CurrentSince Jan 1, 2025 Accepting new patients
DRX Paramus, LLC CurrentSince Feb 24, 2024 Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients

Locations

2001 College Dr
Ste 11
Clementon, NJ 08021
Phone (856) 566-3333

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

276 Passaic Ave
#A
Kearny, NJ 07032
Phone (201) 231-8880

2 Memorial Dr
Lodi, NJ 07644
Phone (551) 837-2051

175 High St
Newton, NJ 07860
Phone (973) 383-2121

222 High St
Ste 205
Newton, NJ 07860
Phone (973) 579-4060

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652
Phone (201) 262-2010

Organizations & group practices 3

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1508643412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DIX CIR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466001",
            "telephone_number": "201-562-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DIX CIR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466001",
            "telephone_number": "201-562-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZEHAJI",
        "first_name": "TIMUR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311321",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ14946600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.