Individual provider Active NPI

Tahira Bokhari, MD

  • Allergy & Immunology Physician
  • Fairlawn, NJ
National Provider Identifier
1619075009
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MA40419 Issued in NJ
Practice address
17-15 Maple Ave
Fairlawn, NJ 07410
Phone
(201) 703-9447
Fax
(201) 703-9097
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MA40419 NJ Primary

Addresses

Primary practice location

17-15 Maple Ave
Fairlawn, NJ 07410

Mailing address

443 East Westfield Ave
Roselle Park, NJ 07204
Phone (908) 241-1611

Other identifiers 1

IdentifierTypeStateIssuer
3231003MedicaidNJ

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
I20110516000631 NJ Practitioner - Allergy/ImmunologyPractitioner - Pediatric MedicinePractitioner - Infectious Disease 1557547130 Reassigns benefits to 1 organization
Practice locations: Roselle Park, NJ; Fairlawn, NJ

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Infectious Disease, Pediatric Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sudhir M Parikh MD PAGroup PAC ID 1153234406, 9 clinicians

Practice addresses (Care Compare)

926 N Wood Ave
Center for Asthma and Allergy
Linden, NJ 07036-4040
Phone (908) 925-3318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA40419NJMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudhir M Parikh M D P a Allergy & Immunology CurrentSince Sep 12, 2023 Accepting new patients
Advanced Diagnostics & Imaging Professional Association Past Accepting new patients

Locations

1018 Broad St
Ste 5
Bloomfield, NJ 07003

17-15 Maple Ave
Ste 110
Fair Lawn, NJ 07410

17-15 Maple Ave
Ste 1
Fair Lawn, NJ 07410
Phone (201) 398-0077

17-15 Maple Ave
Fair Lawn, NJ 07410
Phone (201) 796-1200

18 N 3rd Ave
Highland Park, NJ 08904
Phone (732) 545-0094

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1619075009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 EAST WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "07204",
            "telephone_number": "908-241-1611",
            "fax_number": "908-241-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17-15 MAPLE AVE",
            "city": "FAIRLAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-703-9447",
            "fax_number": "201-703-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOKHARI",
        "first_name": "TAHIRA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "MA40419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3231003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, NJ

Sources for this page

Verify at the official NPI Registry.