NPIMap

Individual provider Active NPI

Ahmed Farouk Attia, D.O.

  • Surgery Physician
  • Vineland, NJ
National Provider Identifier
1669538740
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MB08266100 Issued in NJ
Practice address
1103 West Sherman Avenue
Building 2 Unit C
Vineland, NJ 08360
Phone
(856) 362-5259
Fax
(856) 407-6978
NPI assigned
Dec 31, 2006
Last updated
May 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MB08266100 NJ Primary

Addresses

Primary practice location

1103 West Sherman Avenue
Building 2 Unit C
Vineland, NJ 08360

Mailing address

1103 West Sherman Avenue
Building 2 Unit C
Vineland, NJ 08360
Phone (856) 362-5259

Other identifiers 1

IdentifierTypeStateIssuer
0148911MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000284 NJ Practitioner - General Surgery 1456481480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esa South Jersey Bariatrics, P.a.Group PAC ID 1759560600, 3 clinicians

Practice addresses (Care Compare)

1103 W Sherman Ave
Building 2 Unit C
Vineland, NJ 08360-6912
Phone (856) 362-5259

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.22 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)14
Upper gastrointestinal (GI) endoscopy for acid reflux29
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08266100NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esa South Jersey Bariatrics, P.a. Surgery CurrentSince Nov 1, 2010 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

1103 W Sherman Ave
Ste 2C
Vineland, NJ 08360
Phone (856) 362-5259

Organizations & group practices 2

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 8

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": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1669538740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WEST SHERMAN AVENUE",
            "address_2": "BUILDING 2 UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-362-5259",
            "fax_number": "856-407-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WEST SHERMAN AVENUE",
            "address_2": "BUILDING 2 UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-362-5259",
            "fax_number": "856-407-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTIA",
        "first_name": "AHMED",
        "middle_name": "FAROUK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB08266100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148911",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.