Shafiq Ur Rahman, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD053911-L Issued in PA

Practice address

116 N 5TH St
W Hazleton, PA 18202-3946

Phone

(570) 454-2545

Fax

(570) 454-6191

NPI assigned

Oct 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Early Psychiatric & Counseling Service, P.C

  • Psychiatry Physician
  • W Hazleton, PA
  • NPI 1831390343
  Medicare reassignment NPD Authorized official
• Luzerne Wyoming County Mental Health Center #1

  dba Community Counseling Services of NEPA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilkes Barre, PA
  • NPI 1487774824
  NPD (past)
• Luzerne Wyoming County Mental Health Center #1

  dba Behavioral Health Services of Wyoming Valley

  • Psychiatric Hospital
  • Kingston, PA
  • NPI 1861425159
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689759441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187070100",
            "telephone_number": "570-454-2545",
            "fax_number": "570-454-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N 5TH ST",
            "city": "W HAZLETON",
            "state": "PA",
            "postal_code": "182023946",
            "telephone_number": "570-454-2545",
            "fax_number": "570-454-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "SHAFIQ",
        "middle_name": "UR",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD053911-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015129990009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher D. Justofin,D.O.,P.C.
• Derek Enterprises LLC (Pro Rehabilitiation Services)
• Early Psychiatric & Counseling Service, P.C
• George E Kuzma, D.P.M.
• Neuropedic LLC (Neuropedic)
• Mark J Wende, DDS

• Psychiatry Physician in W Hazleton, PA
• Providers in W Hazleton, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.