NPIMap

Individual provider Active NPI

Ranya M Mustafa

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1679934483
Registry record updated May 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00398700 Issued in NJ
Practice address
3O Prospect Ave
Hackensack, NJ 07601-1902
Phone
(551) 996-3192
Fax
(551) 996-4239
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019570 NY
Physician Assistant 363A00000X 25MP00398700 NJ Primary

Addresses

Primary practice location

3O Prospect Ave
Hackensack, NJ 07601-1902

Mailing address

192 Executive Dr
New Hyde Park, NY 11040-1051
Phone (516) 707-9991

Other practice location 1

192 Executive Dr
New Hyde Park, NY 11040-1051
Phone (516) 707-9991

Other identifiers 1

IdentifierTypeStateIssuer
25MP00398700OtherNJSTATE LICENSE

Other names 1

  • Ranya I Madhoun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170308000242 NJ Practitioner - Physician Assistant 6800170093 Reassigns benefits to 9 organizations
I20231024003456 NY Practitioner - Physician Assistant 6800170093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hunterdon Urgent Care PCGroup PAC ID 9638460876, 23 clinicians

Practice addresses (Care Compare)

2100 Wescott Dr
Flemington, NJ 08822-4603
Phone (908) 237-4036

2100 Wescott Drive Mso 5TH FL
Flemington, NJ 08822-4603

Merit-based Incentive Payment System (MIPS)

Final score
82.61 of 100Reported as group
Quality
76.33
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019570NYMDSpeech-Language Pathologist
25MP00398700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 1, 2020 Accepting new patients
Meridian Medical Group - Specialty Care, PC Past Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

Interoperability endpoints

  • Direct secure messaging: ranya.madhoun@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589068800000",
    "number": "1679934483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 EXECUTIVE DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401051",
            "telephone_number": "516-707-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3O PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011902",
            "telephone_number": "551-996-3192",
            "fax_number": "551-996-4239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "192 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401051",
            "country_code": "US",
            "telephone_number": "516-707-9991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "RANYA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019570",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00398700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MP00398700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANYA",
            "last_name": "MADHOUN",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.