Individual provider Active NPI

Rizwan Ahmad

  • Clinical Psychologist
  • Bethlehem, PA
National Provider Identifier
1740723519
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018186 Issued in PA
Practice address
1 W Broad St
Suite 810
Bethlehem, PA 18018-5717
Phone
(610) 865-4300
NPI assigned
Nov 28, 2016
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS018186 PA Primary

Addresses

Primary practice location

1 W Broad St
Suite 810
Bethlehem, PA 18018-5717

Mailing address

1 W Broad St
Suite 810
Bethlehem, PA 18018-5717
Phone (610) 865-4300

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170125002094 PA Practitioner - Clinical Psychologist 2264714351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Integrated Behavioral Health, LLCGroup PAC ID 4183884521, 10 clinicians

Practice addresses (Care Compare)

1 E Broad St
Suite 510
Bethlehem, PA 18018-5964
Phone (610) 865-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrated Behavioral Health,LLC CurrentSince Dec 1, 2016 Accepting new patients

Locations

1 E Broad St
Ste 510
Bethlehem, PA 18018
Phone (610) 865-4300

1 W Broad St
Ste 810
Bethlehem, PA 18018
Phone (610) 417-4966

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

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1740723519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W BROAD ST",
            "address_2": "SUITE 810",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185717",
            "telephone_number": "610-865-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W BROAD ST",
            "address_2": "SUITE 810",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185717",
            "telephone_number": "610-865-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "RIZWAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.