Active NPI
Cyrus Ahmadi, MD
- Pediatric Adolescent Medicine Physician
- Passaic, NJ
National Provider Identifier
1912901950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- MA032935
- Practice address
- 53 Passaic Ave
Passaic, NJ 07055-4801 - Phone
- (973) 471-4440
- Fax
- (973) 471-4681
- NPI assigned
- Jun 8, 2005
- Last updated
- Sep 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | MA032935 | NJ | Primary |
Addresses
Primary practice location
53 Passaic Ave
Passaic, NJ 07055-4801
Mailing address
53 Passaic Ave
Passaic, NJ 07055-4801
Phone (973) 471-4440
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01000004300 | Other | AMERICHOICE | |
| 0375004 | Other | MEDICAID (UNISYS) | |
| 19981288 | Other | LOCAL 734 | |
| 1035326 | Other | MERCY | |
| 4330670 | Other | AETNA | |
| C64487370 | Other | GUARDIAN | |
| 0101202001 | Other | AMERIHEALTH | |
| 23178 | Other | MEDICHOICE | |
| 441625 | Other | KEYSTONE | |
| PPQ15 | Other | OXFORD | |
| 5318425004 | Other | CIGNA | |
| QK974Q | Other | HEALTHNET | |
| 10509 | Other | AMERIGROUP | |
| 667685 | Other | FIRST HEALTH | |
| 0375004 | Medicaid | NJ | |
| 11073(2534) | Other | US HEALTH | |
| 12708 | Other | UNIVERSITY | |
| 298253 | Other | USA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA032935 | NJ | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285632000000",
"number": "1912901950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 PASSAIC AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554801",
"telephone_number": "973-471-4440",
"fax_number": "973-471-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 PASSAIC AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554801",
"telephone_number": "973-471-4440",
"fax_number": "973-471-4681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMADI",
"first_name": "CYRUS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-08",
"last_updated": "2010-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NJ",
"license": "MA032935",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "01000004300",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID (UNISYS)",
"identifier": "0375004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOCAL 734",
"identifier": "19981288",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "1035326",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4330670",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GUARDIAN",
"identifier": "C64487370",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0101202001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICHOICE",
"identifier": "23178",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "441625",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "PPQ15",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5318425004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "QK974Q",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10509",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "667685",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0375004",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTH",
"identifier": "11073(2534)",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY",
"identifier": "12708",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA",
"identifier": "298253",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.