Individual provider Active NPI

Roya Rahimi, PA-C, CNMT

  • Surgical Physician Assistant
  • Franklin Lakes, NJ
National Provider Identifier
1760880470
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00352500 Issued in NJ
Practice address
784 Franklin Ave
Suite 250
Franklin Lakes, NJ 07417-1306
Phone
(201) 560-0711
Fax
(201) 560-0712
NPI assigned
Dec 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00352500 NJ Primary

Addresses

Primary practice location

784 Franklin Ave
Suite 250
Franklin Lakes, NJ 07417-1306

Mailing address

14 Krakow St
Garfield, NJ 07026-1407
Phone (631) 383-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150424001243 NJ Practitioner - Physician Assistant 4981923919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kayal Medical Group, LLC 76 clinicians

Practice addresses (Care Compare)

260 Old Hook Rd
Suite 401
Westwood, NJ 07675-3123
Phone (844) 777-0910

543 45TH St
Union City, NJ 07087-2615
Phone (844) 777-0910

Hospital & facility affiliations

  • Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rrahimi191571@ahs.direct-ci.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1760880470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KRAKOW ST",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261407",
            "telephone_number": "631-383-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE",
            "address_2": "SUITE 250",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171306",
            "telephone_number": "201-560-0711",
            "fax_number": "201-560-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIMI",
        "first_name": "ROYA",
        "credential": "PA-C, CNMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00352500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

Verify at the official NPI Registry.