Individual provider Active NPI

Mohammad Rizwan, MD

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1811982648
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05960700 Issued in NJ
Practice address
495 N 13TH St
Newark, NJ 07107-1317
Phone
(973) 268-1400
NPI assigned
Sep 19, 2005
Last updated
Feb 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05960700 NJ Primary
General Practice Physician 208D00000X 25MA05960700 NJ

Addresses

Primary practice location

495 N 13TH St
Newark, NJ 07107-1317

Mailing address

66 W Gilbert St
Tinton Falls, NJ 07701-4918
Phone (732) 212-0060

Other identifiers 1

IdentifierTypeStateIssuer
7767901MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051003000508 NJ Practitioner - Internal Medicine 4688609282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inhospital Physicians Corp of New Jersey, PCGroup PAC ID 2264781780, 20 clinicians

Practice addresses (Care Compare)

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

59 Koch Ave
Morris Plains, NJ 07950-4400
Phone (973) 538-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05960700NJMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll CurrentSince Feb 13, 2023 Accepting new patients
Inhospital Physicians Corp of New Jersey, PC Internal Medicine CurrentSince Aug 14, 2024 Accepting new patients
Central Avenue Professional Services, PC CurrentSince Jan 1, 2016 Accepting new patients

Locations

59 Koch Ave
Morris Plains, NJ 07950
Phone (973) 889-4390

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

268 Mlk Jr Blvd
Newark, NJ 07102
Phone (973) 877-2580

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

96 Parkway
Rochelle Park, NJ 07662
Phone (201) 221-2351

96 Parkway
Spc Hosp
Rochelle Park, NJ 07662
Phone (973) 450-2540

81 Northfield Ave
Ste 101
West Orange, NJ 07052
Phone (973) 699-5931

610 Sentry Pkwy
Bldg 660
Blue Bell, PA 19422

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1811982648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014918",
            "telephone_number": "732-212-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZWAN",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05960700",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA05960700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7767901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.