NPIMap

Organization Active NPI

Deepak Amin, M.D., LLC

  • Internal Medicine Physician
  • Union City, NJ
National Provider Identifier
1629219670
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06036000 Issued in NJ
Legal business name
DEEPAK AMIN, M.D., LLC
Practice address
4522 Kennedy Blvd
Union City, NJ 07087-8014
Phone
(201) 863-1797
Fax
(201) 863-6117
NPI assigned
Mar 19, 2009
Last updated
Dec 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Authorized official

Name
Dr. Deepak Amin, M.D.NPI 1659372829
Title
Owner
Phone
(201) 863-1797

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA08374000 NJ
Family Medicine Physician 207Q00000X 25MA08048500 NJ
Family Medicine Physician 207Q00000X 242719 NY
Internal Medicine Physician 207R00000X 25MA06036000 NJ Primary
Internal Medicine Physician 207R00000X 189494 NY

Addresses

Primary practice location

4522 Kennedy Blvd
Union City, NJ 07087-8014

Mailing address

4522 Kennedy Blvd
Union City, NJ 07087-8014
Phone (201) 863-1797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000012 NJ Part B Supplier - Clinic/Group Practice 5597813832 Receives reassigned benefits from 10 practitioners
Practice locations: Union City, NJ; West New York, NJ

National Provider Directory

National Provider Directory

Locations

745 Nostrand Ave
Brooklyn, NY 11216
Phone (718) 735-6700

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1629219670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 KENNEDY BLVD",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070878014",
            "telephone_number": "201-863-1797",
            "fax_number": "201-863-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 KENNEDY BLVD",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070878014",
            "telephone_number": "201-863-1797",
            "fax_number": "201-863-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPAK AMIN, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-863-1797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08374000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08048500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "242719",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06036000",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "189494",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.