Individual provider Active NPI

Ibrahim Raza Pasha, M.D.

  • Nephrology Physician
  • Newburgh, NY
National Provider Identifier
1629331798
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
288684 Issued in NY
Practice address
200 Lake St
Newburgh, NY 12550-5243
Phone
(845) 565-8022
Fax
(845) 565-6349
NPI assigned
Jun 22, 2012
Last updated
Nov 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 288684 NY Primary
Hospitalist Physician 208M00000X 288684 NY

Addresses

Primary practice location

200 Lake St
Newburgh, NY 12550-5243

Mailing address

4107 Ridgecrest Dr
Wappingers Falls, NY 12590-7540

Other practice location 1

45 Reade Pl
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Other identifiers 1

IdentifierTypeStateIssuer
03460982MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120731000546 NY Practitioner - NephrologyPractitioner - Hospitalist 0840456166 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

296 Baileys Gap Rd
Highland, NY 12528-2300
Phone (917) 288-6248

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004058NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Dec 1, 2018 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Oct 15, 2022 Accepting new patients
Pasha Kidney Medical Care PLLC Nephrology CurrentSince Oct 20, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Mar 1, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Current Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Oct 15, 2022 Accepting new patients

Locations

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ipasha127628@direct.aspirus.org

Organizations & group practices 6

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 4

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1629331798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 RIDGECREST DR",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125907540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505243",
            "telephone_number": "845-565-8022",
            "fax_number": "845-565-6349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Reade Pl",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126013947",
            "country_code": "US",
            "telephone_number": "845-454-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASHA",
        "first_name": "IBRAHIM",
        "middle_name": "RAZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "288684",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "288684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03460982",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.