Organization Active NPI

Taj Medical Inc

  • Cardiovascular Disease Physician
  • Springfield, OH
National Provider Identifier
1811914765
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
TAJ MEDICAL INC
Practice address
1174 E Home Rd
Suite N
Springfield, OH 45503-2726
Phone
(937) 398-0354
Fax
(937) 398-0358
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Dr. Tajuddin Ahmed, M.D.NPI 1417959156
Title
President
Phone
(937) 398-0354

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1174 E Home Rd
Suite N
Springfield, OH 45503-2726

Mailing address

1174 E Home Rd
Suite N
Springfield, OH 45503-2726
Phone (937) 398-0354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051114000699 OH Part B Supplier - Clinic/Group Practice 6709805377 Receives reassigned benefits from 8 practitioners
Practice locations: Fairborn, OH; Springfield, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1011394Taj Medical Inc1174 East Home Road Suite N, Springfield, OH 45503Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory

Locations

7774 Dayton Springfield Rd
#B
Fairborn, OH 45324

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1811914765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 E HOME RD",
            "address_2": "SUITE N",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "937-398-0354",
            "fax_number": "937-398-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E HOME RD",
            "address_2": "SUITE N",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "937-398-0354",
            "fax_number": "937-398-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAJ MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "TAJUDDIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-398-0354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.