NPIMap

Organization Active NPI

Amir Reza Radjabi Medical PLLC

Doing business as New Heritage Fertility PLLC

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1639791155
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
AMIR REZA RADJABI MEDICAL PLLC
Doing business as
New Heritage Fertility PLLC
Practice address
240 Central Park S Apt 1P
New York, NY 10019-1429
Phone
(212) 535-5350
NPI assigned
May 7, 2020
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Amir Reza Radjabi, MD
Title
Medical Director
Phone
(917) 444-5444

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary
Reproductive Endocrinology Physician 207VE0102X

Addresses

Primary practice location

240 Central Park S Apt 1P
New York, NY 10019-1429

Mailing address

240 Central Park S Apt 1P
New York, NY 10019-1429
Phone (800) 750-8616

Other identifiers 1

IdentifierTypeStateIssuer
4897536MedicaidNY

Other names 1

  • NEW HERITAGE FERTILITY PLLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221025000077 NY Part B Supplier - Clinic/Group Practice 0446626972 Receives reassigned benefits from 8 practitioners
Practice locations: New York, NY

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
33D2284491Amir Reza Radjabi Medical PLLC240 Central Park South #2N, New York, NY 10019Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1639791155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CENTRAL PARK S APT 1P",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191429",
            "telephone_number": "800-750-8616",
            "fax_number": "845-362-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CENTRAL PARK S APT 1P",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191429",
            "telephone_number": "212-535-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIR REZA RADJABI MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "RADJABI",
        "authorized_official_first_name": "AMIR REZA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-444-5444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4897536",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW HERITAGE FERTILITY PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.