Individual provider Active NPI

Shama Safdar, PA-C

  • Physician Assistant
  • Princeton, NJ
National Provider Identifier
1669041489
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00631800 Issued in NJ
Practice address
325 Princeton Ave
Princeton, NJ 08540-1617
Phone
(609) 924-8131
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00631800 NJ Primary

Addresses

Primary practice location

325 Princeton Ave
Princeton, NJ 08540-1617

Mailing address

325 Princeton Ave
Princeton, NJ 08540-1617
Phone (609) 924-8131

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817002684 NJ Practitioner - Physician Assistant 2365847183 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00631800NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Aug 9, 2021 Accepting new patients
Orthonj LLC CurrentSince Aug 12, 2023 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Aug 9, 2021 Accepting new patients
Orthonj LLC CurrentSince Aug 12, 2023 Accepting new patients

Locations

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

999 Route 73 N
Ste 401
Marlton, NJ 08053

4301 US Highway 1
Ste 300
Monmouth Junction, NJ 08852

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

325 Princeton Ave
Princeton, NJ 08540
Phone (609) 924-5044

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

Organizations & group practices 4

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": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1669041489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFDAR",
        "first_name": "SHAMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00631800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.