Active NPI
Saman Ebrahimzadeh
- Physical Therapy Assistant
- Newark, NJ
National Provider Identifier
1780341966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40QB00389300
- Practice address
- 225 McWhorter Street
Newark, NJ 07105 - Phone
- (973) 494-0858
- Fax
- (844) 857-2827
- NPI assigned
- Nov 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 40QB00389300 | NJ | Primary |
Addresses
Primary practice location
225 McWhorter Street
Newark, NJ 07105
Mailing address
414 Hackensack Ave Apt 1406
Hackensack, NJ 07601-6581
Phone (201) 406-5273
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QB00389300 | NJ | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Airon PT LLC | Current | Accepting new patients |
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.
-
- Physical Therapist
- Newark, NJ
- NPI 1285877332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1780341966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 HACKENSACK AVE APT 1406",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076016581",
"telephone_number": "201-406-5273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MCWHORTER STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07105",
"telephone_number": "973-494-0858",
"fax_number": "844-857-2827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBRAHIMZADEH",
"first_name": "SAMAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-22",
"last_updated": "2021-11-22",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40QB00389300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.