Organization Active NPI

Nudrat F Ayub MD LLC

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1609012525
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08288800 Issued in NJ
Legal business name
NUDRAT F AYUB MD LLC
Practice address
166 Lyons Ave
Newark, NJ 07112-2016
Phone
(973) 926-3444
NPI assigned
Dec 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Authorized official

Name
Nudrat F Ayub, MDNPI 1346430774
Title
Member
Phone
(973) 926-3444

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA08288800 NJ Primary

Addresses

Primary practice location

166 Lyons Ave
Newark, NJ 07112-2016

Mailing address

166 Lyons Ave
Newark, NJ 07112-2016
Phone (973) 926-3444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090209000485 NJ Part B Supplier - Clinic/Group Practice 9537224514 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2001757Nudrat Ayub MD, LLC166 Lyons Avenue, Ground F1, Newark, NJ 07112Certificate of waiverDec 29, 2027

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": "1229990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229990400000",
    "number": "1609012525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122016",
            "telephone_number": "973-926-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122016",
            "telephone_number": "973-926-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDRAT F AYUB MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A",
        "authorized_official_last_name": "AYUB",
        "authorized_official_first_name": "NUDRAT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "973-926-3444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08288800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.