Individual provider Active NPI

Ahmed A Razeq, M.D.

  • Pediatrics Physician
  • Clifton Park, NY
National Provider Identifier
1912352121
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
312126 Issued in NY
Practice address
1 Tallow Wood Dr
Clifton Park, NY 12065-2807
Phone
(518) 688-0295
Fax
(518) 383-7330
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 312126 NY Primary

Addresses

Primary practice location

1 Tallow Wood Dr
Clifton Park, NY 12065-2807

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

532 Moe Rd
Clifton Park, NY 12065-3822
Phone (518) 383-2425

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250604000989 NY Practitioner - Pediatric Medicine 4183133895 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312126NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
Four Seasons Pediatrics, LLC Pediatrics Current Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Jul 1, 2025 Accepting new patients
Four Seasons Pediatrics, LLC Pediatrics Current Accepting new patients

Locations

532 Moe Rd
Clifton Park, NY 12065
Phone (518) 243-3322

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (314) 400-4416

Interoperability endpoints

  • Direct secure messaging: ahmed.razeq.p1@direct.cwpw.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1912352121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TALLOW WOOD DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652807",
            "telephone_number": "518-688-0295",
            "fax_number": "518-383-7330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "532 Moe Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653822",
            "country_code": "US",
            "telephone_number": "518-383-2425",
            "fax_number": "518-383-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZEQ",
        "first_name": "AHMED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "312126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1 Tallow Wood Dr",
            "city": "Clifton Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120652807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.