Maryam B. Abdur-Rahman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0000648 Issued in DE

Practice address

4755 Ogletown Stanton Road
Christiana Hospital Dept of Surgery, Suite 2670
Newark, DE 19718-2200

Phone

(302) 584-2601

Fax

(302) 733-4832

NPI assigned

Feb 24, 2009

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Christiana Care Health Services Inc

  dba CCHS Gastroenterology

  • Gastroenterology Physician
  • Newark, DE
  • NPI 1487083069
  NPD
• Christiana Care Health Services, Inc

  dba CCHS Surgery

  • Surgery Physician
  • Newark, DE
  • NPI 1407831894

  Physician Assistant

  NPD
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855

  Physician Assistant

  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Christiana Care Health Services Inc

  dba CCHS Concord - Neurology

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Atlantic Physician Services of Maryland, P.C.

  • Physician Assistant
  • Wilmington, DE
  • NPI 1730129594
  NPD (past)
• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  NPD (past)

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1730329202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE",
            "address_2": "CCHS PHYSICIAN CONTRACTING, SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "address_2": "CHRISTIANA HOSPITAL DEPT OF SURGERY, SUITE 2670",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-584-2601",
            "fax_number": "302-733-4832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDUR-RAHMAN",
        "first_name": "MARYAM",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "CS-0000648",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000648",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "013645",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "061668248",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abby Medical Center Cardiac Rehabilitation LLC
• Abby Medical, LLC (Go Care at Abby)
• Amir Abdel Kader, MD
• Raafat Z Abdel-Misih, MD
• Abdel-Misih/Bennett, MDS, PA
• Ketaki Vijay Abhyankar, M.D.
• Paolo Abiad, M.D.
• Abigail Family Practice, LLC
• Abigail Internal Medicine (Abigail Internal Medicine LLC)
• Abigail Medical Family Medicine, L.L.C. (Abigail Family Medicine LLC)

• Physician Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.