Organization Active NPI

Med-Doc Office PC

  • Psychiatry Physician
  • Stratford, NJ
National Provider Identifier
1851021372
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MED-DOC OFFICE PC
Practice address
11 E Laurel Rd
Stratford, NJ 08084-1322
Phone
(609) 922-5260
Fax
(856) 912-8135
NPI assigned
Jun 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Authorized official

Name
Rowsonara Akhter, MDNPI 1477844421
Title
Physician
Phone
(609) 922-5260

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

11 E Laurel Rd
Stratford, NJ 08084-1322

Mailing address

9 Wilderness Dr
Voorhees, NJ 08043-3415
Phone (609) 922-5260

Other practice location 1

4016 Ventnor Ave # Unite1
Atlantic City, NJ 08401-5933
Phone (609) 922-5260

Other practice location 2

602 Broadway
Camden, NJ 08103-1222
Phone (609) 922-5260

Other identifiers 1

IdentifierTypeStateIssuer
0959588MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221101000120 NJ Part B Supplier - Clinic/Group Practice 9436526621 Receives reassigned benefits from 6 practitioners
Practice locations: Atlantic City, NJ; Camden, NJ; Stratford, NJ

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
31D2270717Med-Doc Office PC11 E Laurel Road, Stratford, NJ 08084Certificate of waiverOct 19, 2026
31D2270718Med-Doc Office PC4016 Ventnor Ave, Atlantic City, NJ 08401Certificate of waiverOct 19, 2026
31D2290145Med-Doc Office PC602 Broadway, Camden, NJ 08103Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory

Locations

602 Broadway
Camden, NJ 08103
Phone (609) 922-5260

Practitioners & affiliated clinicians

Practitioners 6

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": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717200000000",
    "number": "1851021372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WILDERNESS DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433415",
            "telephone_number": "609-922-5260",
            "fax_number": "856-912-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841322",
            "telephone_number": "609-922-5260",
            "fax_number": "856-912-8135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4016 Ventnor Ave # Unite1",
            "address_purpose": "LOCATION",
            "city": "Atlantic City",
            "state": "NJ",
            "postal_code": "084015933",
            "country_code": "US",
            "telephone_number": "609-922-5260",
            "fax_number": "856-912-8135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "602 Broadway",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031222",
            "country_code": "US",
            "telephone_number": "609-922-5260",
            "fax_number": "856-912-8135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MED-DOC OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A",
        "authorized_official_last_name": "AKHTER",
        "authorized_official_first_name": "ROWSONARA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "609-922-5260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0959588",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; 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.