Active NPI
S Manzoor Abidi, MD
- Neurology Physician
- Maple Shade, NJ
National Provider Identifier
1508816729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MA025082
- Practice address
- 504 Route 38 E
Maple Shade, NJ 08052 - Phone
- (856) 866-0466
- Fax
- (856) 727-1483
- NPI assigned
- May 10, 2006
- Last updated
- Jul 30, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MA025082 | NJ | Primary |
Addresses
Primary practice location
504 Route 38 E
Maple Shade, NJ 08052
Mailing address
504 Route 38 E
Maple Shade, NJ 08052
Phone (856) 866-0466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3670503 | Medicaid | NJ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110225000384 | NJ | Practitioner - Neurology | 4385639012 |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 1962
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
504 Route 38 E
Maple Shade, NJ 08052-2039
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA025082 | NJ | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1508816729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 ROUTE 38 E",
"city": "MAPLE SHADE",
"state": "NJ",
"postal_code": "08052",
"telephone_number": "856-866-0466",
"fax_number": "856-727-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 ROUTE 38 E",
"city": "MAPLE SHADE",
"state": "NJ",
"postal_code": "08052",
"telephone_number": "856-866-0466",
"fax_number": "856-727-1483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABIDI",
"first_name": "S",
"middle_name": "MANZOOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NJ",
"license": "MA025082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3670503",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Shade, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.