Individual provider Active NPI

Thomas Ahmed Ibrahim Roshdi, RPH

  • Pharmacist
  • Union City, NJ
National Provider Identifier
1912525346
Registry record updated Aug 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04012900 Issued in NJ
Practice address
4313 Bergenline Ave
Union City, NJ 07087-5067
Phone
(201) 758-5159
NPI assigned
Jul 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04012900 NJ Primary

Addresses

Primary practice location

4313 Bergenline Ave
Union City, NJ 07087-5067

Mailing address

3252 35TH St
Astoria, NY 11106-1102
Phone (917) 391-3902

Other identifiers 1

IdentifierTypeStateIssuer
28RI04012900OtherNJPHARMACIST LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Wireless Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI04012900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Friendly RXGS Current Accepting new patients
Shreeji RX LLC PastSince Jul 19, 2020 Accepting new patients

Organizations & group practices 2

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596931200000",
    "number": "1912525346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3252 35TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111061102",
            "telephone_number": "917-391-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 BERGENLINE AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875067",
            "telephone_number": "201-758-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHDI",
        "first_name": "THOMAS AHMED",
        "middle_name": "IBRAHIM",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04012900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "28RI04012900",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Wireless",
            "affiliation": "N",
            "endpointDescription": "NPI",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4313 Bergenline Ave",
            "city": "Union City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070875067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.