Individual provider Active NPI

Qasim Kaleem Khawaja

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
National Provider Identifier
1790513828
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ15422300 Issued in NJ
Practice address
65 Bergen St # 1119a
Newark, NJ 07107-3001
Phone
(917) 753-1734
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NJ15422300 NJ Primary

Addresses

Primary practice location

65 Bergen St # 1119a
Newark, NJ 07107-3001

Mailing address

1489 Shore Pkwy Apt 3a
Brooklyn, NY 11214-6321
Phone (917) 753-1734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260623000955 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012480908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15422300NJMDCertified Registered Nurse Anesthetist

Organizations & group practices 2

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 2

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1790513828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 SHORE PKWY APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146321",
            "telephone_number": "917-753-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BERGEN ST # 1119A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073001",
            "telephone_number": "917-753-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAWAJA",
        "first_name": "QASIM",
        "middle_name": "KALEEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15422300",
            "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 Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.