Ahmad Izzat Al-Awwa, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

7600 River Rd
North Bergen, NJ 07047-6217

Phone

(201) 710-2716

NPI assigned

Mar 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, MI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1659909414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 RIVER RD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476217",
            "telephone_number": "201-710-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 RIVER RD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476217",
            "telephone_number": "201-710-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-AWWA",
        "first_name": "AHMAD",
        "middle_name": "IZZAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA12084100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ak Nutrition and Wellness LLC
• Vaidehi Sunilkumar Akhani, M.D.
• Jenny Akpe, MD
• Ali Al-Amrany
• Amran Al-Amrany, MD
• Mohammed Fares Al-Zubidi
• Alvaro Alban, MD
• Mylene Alberto, APN
• Carlos E Alcorta, MD, FACC
• Damaris Alfonso

• Student in an Organized Health Care Education/Training Program in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.