Individual provider Active NPI

Ahmad Jamal Javed

  • Geriatric Medicine (Family Medicine) Physician
  • New York, NY
National Provider Identifier
1982286779
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
331083 Issued in NY
Practice address
170 East 77TH Street
Suite B
New York, NY 10075
Phone
(347) 448-3044
NPI assigned
Apr 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Family Medicine) Physician 207QG0300X 331083 NY Primary

Addresses

Primary practice location

170 East 77TH Street
Suite B
New York, NY 10075

Mailing address

170 East 77TH Street
Suite B
New York, NY 10075
Phone (347) 448-3044

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
I20250707001532 NY Practitioner - Geriatric MedicinePractitioner - Family Practice 0648676858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 18, 2025 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ajaved365844@northwell.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1982286779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 EAST 77TH STREET",
            "address_2": "SUITE B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "347-448-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 EAST 77TH STREET",
            "address_2": "SUITE B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "347-448-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVED",
        "first_name": "AHMAD",
        "middle_name": "JAMAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "331083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.