Organization Active NPI

Infiniteaxon LLC

  • Neurology Physician
  • Bridgewater, NJ
National Provider Identifier
1528893229
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
INFINITEAXON LLC
Doing business as
BRIDGEWATER NEUROLOGY
Practice address
745 Route 202/206 Ste 105
Bridgewater, NJ 08807-1758
Phone
(302) 853-7032
Fax
(908) 548-9201
NPI assigned
Sep 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Dr. Imran Khan, M.DNPI 1669728556
Title
Neurologist/Ceo
Phone
(302) 853-7032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

745 Route 202/206 Ste 105
Bridgewater, NJ 08807-1758

Mailing address

745 Route 202/206 Ste 105
Bridgewater, NJ 08807-1758
Phone (302) 853-7032

Other practice location 1

11 History Ln
Jackson Township, NJ 08527
Phone (302) 853-7032

Other practice location 2

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2200

Other practice location 3

875 Route 202/206
Bridgewater, NJ 08807-1861
Phone (908) 526-8600

Other names 1

  • BRIDGEWATER NEUROLOGY Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bridgewaterneurology@outlook.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250213000604 NJ Part B Supplier - Clinic/Group Practice 4587194063 Receives reassigned benefits from 1 practitioner
Practice locations: Bridgewater, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1528893229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 ROUTE 202/206 STE 105",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071758",
            "telephone_number": "302-853-7032",
            "fax_number": "908-548-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 ROUTE 202/206 STE 105",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071758",
            "telephone_number": "302-853-7032",
            "fax_number": "908-548-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 History Ln",
            "address_purpose": "LOCATION",
            "city": "Jackson Township",
            "state": "NJ",
            "postal_code": "08527",
            "country_code": "US",
            "telephone_number": "302-853-7032",
            "fax_number": "908-548-9201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Rehill Ave",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "NJ",
            "postal_code": "088762519",
            "country_code": "US",
            "telephone_number": "908-685-2200",
            "fax_number": "908-548-9201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Route 202/206",
            "address_purpose": "LOCATION",
            "city": "Bridgewater",
            "state": "NJ",
            "postal_code": "088071861",
            "country_code": "US",
            "telephone_number": "908-526-8600",
            "fax_number": "908-548-9201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INFINITEAXON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "NEUROLOGIST/CEO",
        "authorized_official_telephone_number": "302-853-7032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bridgewaterneurology@outlook.com",
            "affiliation": "N",
            "endpointDescription": "secure email for business",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "745 Route 202/206 Ste 105",
            "city": "Bridgewater",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088071758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BRIDGEWATER NEUROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.