Active NPI
Amany Samir Ismaiel, MD
- Pediatrics Physician
- Clifton, NJ
National Provider Identifier
1710472139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA10952600
- Practice address
- 162 5TH St
Clifton, NJ 07011-3100 - Phone
- (862) 290-1968
- NPI assigned
- Jun 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 25MA10952600 | NJ | Primary |
Addresses
Primary practice location
162 5TH St
Clifton, NJ 07011-3100
Mailing address
162 5TH St
Clifton, NJ 07011-3100
Phone (862) 290-1968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA10952600 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Medical Group | Past | Accepting new patients |
Interoperability endpoints
- aismaiel77071@direct.optum.com
Organizations & group practices 1
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.
-
- Nurse Practitioner
- Secaucus, NJ
- NPI 1053867598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653436800000",
"number": "1710472139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 5TH ST",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070113100",
"telephone_number": "862-290-1968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 5TH ST",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070113100",
"telephone_number": "862-290-1968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISMAIEL",
"first_name": "AMANY",
"middle_name": "SAMIR",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-27",
"last_updated": "2022-05-25",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA10952600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.