Individual provider Active NPI

Rafeul Huda, MD

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1982798294
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03718000 Issued in NJ
Practice address
240 Williamson St
Suite 506
Elizabeth, NJ 07202-3674
Phone
(908) 352-4579
Fax
(908) 352-3540
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03718000 NJ Primary

Addresses

Primary practice location

240 Williamson St
Suite 506
Elizabeth, NJ 07202-3674

Mailing address

240 Williamson St
Elizabeth, NJ 07202-3674
Phone (908) 352-4579

Other identifiers 2

IdentifierTypeStateIssuer
0409405MedicaidNJ
442158OtherNJPTAN

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
I20060112000212 NJ Practitioner - Internal Medicine 8527081843 Practice locations: Elizabeth, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

240 Williamson St
Elizabeth, NJ 07202-3673
Phone (908) 352-4579

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03718000NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Primary Care, LLC Internal Medicine PastSince Jul 1, 2003 Accepting new patients

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1982798294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-352-4579",
            "fax_number": "908-352-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 506",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-352-4579",
            "fax_number": "908-352-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDA",
        "first_name": "RAFEUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03718000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409405",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "442158",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.