Individual provider Active NPI

Marwa Mohamed Hazzah, M.D.

  • Internal Medicine Physician
  • Lyndhurst, NJ
National Provider Identifier
1891956876
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08680300 Issued in NJ
Practice address
612 Rutherford Ave
Lyndhurst, NJ 07071-1217
Phone
(201) 460-0063
Fax
(201) 460-1684
NPI assigned
Jun 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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 254409 NY
Internal Medicine Physician 207R00000X 25MA08680300 NJ Primary

Addresses

Primary practice location

612 Rutherford Ave
Lyndhurst, NJ 07071-1217

Mailing address

612 Rutherford Ave
Lyndhurst, NJ 07071-1217
Phone (201) 460-0063

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
I20110201000411 NJ Practitioner - Internal Medicine 6406982800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHMG - United MedicalGroup PAC ID 5193949865, 28 clinicians

Practice addresses (Care Compare)

533 Lexington Ave
Clifton, NJ 07011-1923
Phone (973) 546-6844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
254409NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHMG - United Medical Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

988 Broadway
Ste 201
Bayonne, NJ 07002
Phone (201) 339-6111

533 Lexington Ave
Ste 1
Clifton, NJ 07011

533 Lexington Ave
Clifton, NJ 07011
Phone (973) 546-6844

612 Rutherford Ave
Lyndhurst, NJ 07071
Phone (200) 460-0063

Interoperability endpoints

  • Direct secure messaging: mhazzah123869@epicdirect.rwjbh.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1214092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1891956876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RUTHERFORD AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711217",
            "telephone_number": "201-460-0063",
            "fax_number": "201-460-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 RUTHERFORD AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711217",
            "telephone_number": "201-460-0063",
            "fax_number": "201-460-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZZAH",
        "first_name": "MARWA",
        "middle_name": "MOHAMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-22",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254409",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08680300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

Verify at the official NPI Registry.