Organization Active NPI

Prima Med Medical & Headache Center LLC

  • Internal Medicine Physician
  • Allentown, PA
National Provider Identifier
1790535169
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIMA MED MEDICAL & HEADACHE CENTER LLC
Practice address
3131 College Heights Blvd Ste 300
Allentown, PA 18104-4858
Phone
(484) 350-3613
Fax
(484) 350-3141
NPI assigned
Mar 26, 2024
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Razan Asaad, MDNPI 1497048391
Title
President
Phone
(484) 350-3613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X

Addresses

Primary practice location

3131 College Heights Blvd Ste 300
Allentown, PA 18104-4858

Mailing address

1336 Ashley LN
Allentown, PA 18103-9752
Phone (610) 756-7785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529003066 PA Part B Supplier - Clinic/Group Practice 1658713128 Receives reassigned benefits from 1 practitioner
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1790535169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 ASHLEY LN",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181039752",
            "telephone_number": "610-756-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD STE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044858",
            "telephone_number": "484-350-3613",
            "fax_number": "484-350-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA MED MEDICAL & HEADACHE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "ASAAD",
        "authorized_official_first_name": "RAZAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-350-3613",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.