Individual provider Active NPI

Nishawn Rahaman, DO

  • Pediatrics Physician
  • Wilmington, DE
National Provider Identifier
1679328249
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OT023617 Issued in PA
Practice address
1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607
Phone
(302) 651-5874
Fax
(302) 651-5954
NPI assigned
Apr 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OT023617 PA Primary

Addresses

Primary practice location

1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607

Mailing address

1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240910002836 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8224578810

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1679328249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD STE 3D16",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD STE 3D16",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-5874",
            "fax_number": "302-651-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHAMAN",
        "first_name": "NISHAWN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OT023617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.