Individual provider Active NPI

Ali R Surahio, M.D.

  • Psychiatry Physician
  • Elizabeth, NJ
National Provider Identifier
1558764910
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA09574700 Issued in NJ
Practice address
655 E Jersey St
Elizabeth, NJ 07206-1259
Phone
(908) 994-7207
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA09574700 NJ Primary

Addresses

Primary practice location

655 E Jersey St
Elizabeth, NJ 07206-1259

Mailing address

655 E Jersey St
Elizabeth, NJ 07206-1259
Phone (908) 994-7207

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528001803 NJ Practitioner - Psychiatry 3173843372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eoh Acquisition Group, LLCGroup PAC ID 4082009717, 38 clinicians

Practice addresses (Care Compare)

300 Central Ave
East Orange, NJ 07018-2819
Phone (973) 414-3473

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eoh Acquisition Group, LLC CurrentSince Apr 25, 2024 Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Jan 6, 2025 Accepting new patients
Eoh Acquisition Group, LLC Psychiatry CurrentSince Apr 25, 2024 Accepting new patients
Jersey City Medical Center Past Accepting new patients
Jersey City Medical Center Past Accepting new patients

Locations

240 Central Ave
Fl 2
East Orange, NJ 07018

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

300 Central Ave
Fl 3
East Orange, NJ 07018
Phone (973) 414-6806

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

395 Grand St
Jersey City, NJ 07302
Phone (201) 915-2600

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1558764910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061259",
            "telephone_number": "908-994-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061259",
            "telephone_number": "908-994-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURAHIO",
        "first_name": "ALI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09574700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.