Provider profile

Sadia GhafoorDO

Internal Medicine, Rheumatology

NPI 1275722951
508 Lakehurst Rd, Suite Ia, Toms River, NJ 08755732-431-4335

Check your plan

Medicare Advantage plans for Ocean County, NJ.

Checked Oct 25, 2026

Use the name or plan ID on your member card, or choose your insurance company.

Directory results See what each insurance company reports

The 40 Medicare Advantage plans we show for Ocean County, NJ in 2027

  • 18 list Sadia
  • 22 not listed

Aetna Medicare

9 plans list Sadia; not listed on 1 other plan.

9plans
  • Aetna Medicare Eagle Giveback (HMO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 101 Prospect St, Ste 107, Lakewood, NJ, 08701
    • 177 Main St, Matawan, NJ, 07747
    • 2333 Whitehorse Mercerville Rd, Ste J, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    HMONo drug coverage4 starsH3152-045-000Medicare.gov
    $0a month
  • Aetna Medicare Eagle Giveback (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 101 Prospect St, Ste 107, Lakewood, NJ, 08701
    • 177 Main St, Matawan, NJ, 07747
    • 2333 Whitehorse Mercerville Rd, Ste J, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    PPONo drug coverage4 starsH5521-504-000Medicare.gov
    $0a month
  • Aetna Medicare Signature Extra (HMO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 101 Prospect St, Ste 107, Lakewood, NJ, 08701
    • 177 Main St, Matawan, NJ, 07747
    • 2333 Whitehorse Mercerville Rd, Ste J, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    HMODrug coverage4 starsH3152-082-000Medicare.gov
    $0a month
  • Aetna Medicare Elite (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 101 Prospect St, Ste 107, Lakewood, NJ, 08701
    • 177 Main St, Matawan, NJ, 07747
    • 2333 Whitehorse Mercerville Rd, Ste J, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    PPODrug coverage4 starsH5521-123-000Medicare.gov
    $65a month

Clover Health

4 plans list Sadia.

4plans
  • Clover Health Choice (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1451 Route 88, Brick, NJ, 08724
    • 2279 Highway 33, Ste 505, Trenton, NJ, 08690
    • 177 Main St, Matawan, NJ, 07747
    • 2080 State Route 35, Holmdel, NJ, 07733
    • 1245 Whitehorse Mercerville Rd, Ste 418, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 200 Perrine Rd, Ste 223, Old Bridge, NJ, 08857
    • 1440 Pennington Rd, Ste 1, Ewing, NJ, 08618

    This result applies to these offices. Other locations are not confirmed.

    PPODrug coverage5 starsH5141-032-000Medicare.gov
    $0a month
  • Clover Health Choice Giveback (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1451 Route 88, Brick, NJ, 08724
    • 2279 Highway 33, Ste 505, Trenton, NJ, 08690
    • 177 Main St, Matawan, NJ, 07747
    • 2080 State Route 35, Holmdel, NJ, 07733
    • 1245 Whitehorse Mercerville Rd, Ste 418, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 200 Perrine Rd, Ste 223, Old Bridge, NJ, 08857
    • 1440 Pennington Rd, Ste 1, Ewing, NJ, 08618

    This result applies to these offices. Other locations are not confirmed.

    PPODrug coverage5 starsH5141-054-000Medicare.gov
    $0a month
  • Clover Health Valor (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1451 Route 88, Brick, NJ, 08724
    • 2279 Highway 33, Ste 505, Trenton, NJ, 08690
    • 177 Main St, Matawan, NJ, 07747
    • 2080 State Route 35, Holmdel, NJ, 07733
    • 1245 Whitehorse Mercerville Rd, Ste 418, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 200 Perrine Rd, Ste 223, Old Bridge, NJ, 08857
    • 1440 Pennington Rd, Ste 1, Ewing, NJ, 08618

    This result applies to these offices. Other locations are not confirmed.

    PPONo drug coverage5 starsH5141-061-000Medicare.gov
    $0a month
  • Clover Health Choice Value (PPO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1451 Route 88, Brick, NJ, 08724
    • 2279 Highway 33, Ste 505, Trenton, NJ, 08690
    • 177 Main St, Matawan, NJ, 07747
    • 2080 State Route 35, Holmdel, NJ, 07733
    • 1245 Whitehorse Mercerville Rd, Ste 418, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 200 Perrine Rd, Ste 223, Old Bridge, NJ, 08857
    • 1440 Pennington Rd, Ste 1, Ewing, NJ, 08618

    This result applies to these offices. Other locations are not confirmed.

    PPODrug coverage5 starsH5141-042-000Medicare.gov
    $36.30a month

Wellpoint

2 plans list Sadia.

2plans
  • Wellpoint Kidney Care (HMO-POS C-SNP)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1245 Whitehorse Mercerville Rd, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    HMO-POSFor people with certain chronic conditionsDrug coverage3 starsH3240-017-000Medicare.gov
    $0a month
  • Wellpoint Full Dual Advantage (HMO D-SNP)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1245 Whitehorse Mercerville Rd, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    HMOFor people with Medicare and MedicaidDrug coverage3 starsH3240-013-000Medicare.gov
    $30.70a month

AmeriHealth

1 plan lists Sadia.

1plan
  • AmeriHealth Medicare Classic Rx (HMO)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 52 Skyline Dr, Ringwood, NJ, 07456

    This result applies to these offices. Other locations are not confirmed.

    HMODrug coverageH6407-002-000Medicare.gov
    $0a month

Horizon Blue Cross Blue Shield of New Jersey

1 plan lists Sadia.

1plan
  • Horizon NJ TotalCare (HMO D-SNP)

    Source: Medicare.gov provider data.

    Listed offices for this plan:

    • 1245 Whitehorse Mercerville Rd, Ste 418, Hamilton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 2333 Whitehorse Mercerville Rd, Ste J, Hamilton, NJ, 08619

    This result applies to these offices. Other locations are not confirmed.

    HMOFor people with Medicare and MedicaidDrug coverage4 starsH8298-001-000Medicare.gov
    $36.30a month

Humana

1 plan lists Sadia; not listed on 1 other plan.

1plan
  • Humana Gold Plus H6622-100 (HMO)

    Source: Humana provider directory.

    Listed offices for this plan:

    • 2333 Whitehorse Mercerville Rd, Ste J, Trenton, NJ, 08619
    • 1245 Whitehorse Mercerville Rd, Ste 418, Trenton, NJ, 08619
    • 1440 Pennington Rd, Ste 1, Ewing, NJ, 08618

    This result applies to these offices. Other locations are not confirmed.

    HMODrug coverage4 starsH6622-100-001Medicare.gov
    $0a month

Devoted

Not listed on its 6 plans here. That isn't proof they're out of network.

UnitedHealthcare

Not listed on its 11 plans here. That isn't proof they're out of network.

Wellcare

Not listed on its 3 plans here. That isn't proof they're out of network.

Premiums are each plan's own monthly premium, as filed with Medicare. You keep paying your Medicare Part B premium.

Can't find your plan?Tell us the plan you have, and a licensed Silverpath advisor will check whether Sadia takes it. Free.

Original Medicare status

Most Medicare Supplement (Medigap) policies have no provider network: they help pay Original Medicare's cost sharing where Medicare is accepted. Medicare SELECT policies can require network providers for full benefits. Ask the office whether they accept Medicare.

Medicare enrollment and assignment have not been verified here. Advantage directory results do not answer this question.

No opt-out record in this CMS file. CMS's file covers data through 2026-08-31. This does not establish Medicare enrollment, assignment, or whether the office accepts new Medicare patients.

CMS opt-out source · Data through 2026-08-31 · Reviewed Oct 25, 2026

Compare Supplement plans

Practice location

508 Lakehurst Rd, Suite Ia
Toms River, NJ 08755

NPI Registry
NPI issued
2007
Registry record updated
Aug 31, 2010

Medicare's clinician details aren't available on this page yet.

Common questions

Which 2027 Medicare Advantage plans list Sadia Ghafoor?

In Ocean County, NJ, 18 Medicare Advantage plans for 2027 list Sadia in provider data from Medicare.gov or the carrier, including Aetna Medicare Eagle Giveback (HMO), Aetna Medicare Eagle Giveback (PPO) and Aetna Medicare Signature Extra (HMO). CMS matches apply to the covered offices shown with each plan; other offices are not confirmed. Networks can change during the year, so confirm with the office or the plan before you enroll.

Does Sadia Ghafoor take Aetna Medicare Medicare Advantage plans?

Medicare.gov provider data lists Sadia on 9 Medicare Advantage plans for 2027 in Ocean County, NJ, including Aetna Medicare Eagle Giveback (HMO) and Aetna Medicare Eagle Giveback (PPO). 1 other plan did not return a listing in the search area. CMS matches apply to the covered offices shown with each plan; other offices are not confirmed. Confirm with the office or Aetna Medicare before you enroll.

Does Sadia Ghafoor take Clover Health Medicare Advantage plans?

Medicare.gov provider data lists Sadia on 4 Medicare Advantage plans for 2027 in Ocean County, NJ, including Clover Health Choice (PPO) and Clover Health Choice Giveback (PPO). CMS matches apply to the covered offices shown with each plan; other offices are not confirmed. Confirm with the office or Clover Health before you enroll.

Does Sadia Ghafoor take Wellpoint Medicare Advantage plans?

Medicare.gov provider data lists Sadia on 2 Medicare Advantage plans for 2027 in Ocean County, NJ, including Wellpoint Kidney Care (HMO-POS C-SNP) and Wellpoint Full Dual Advantage (HMO D-SNP). CMS matches apply to the covered offices shown with each plan; other offices are not confirmed. Confirm with the office or Wellpoint before you enroll.

Where does Sadia Ghafoor practice?

508 Lakehurst Rd, Suite Ia, Toms River, NJ 08755.

How do I confirm Sadia is in my plan's network?

Call the member services number on your plan card and give them the NPI 1275722951, or ask a Silverpath advisor to check for you. It's free.

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A Silverpath advisor can confirm Sadia's networks with the carrier and help you compare plans that include them.

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For providers

Is this your practice?

What patients see here today:

  • Provider searches did not return a listing for Sadia Ghafoor on 20 plans from Devoted, UnitedHealthcare and Wellcare in Ocean County, NJ. Other offices are not confirmed; this isn't proof the practice is out of network.

Tell us which plans you take, or want to take, and we'll keep this page accurate and talk with you about reaching more Medicare patients and carriers.

Sources. Name, specialty and locations: the CMS NPI Registry (record updated 2010-08-31). Plan networks: carrier provider directories and Medicare.gov provider data, checked Oct 25, 2026. CMS matches apply to the covered offices shown with each plan. Plans: CMS 2027 Medicare Advantage landscape.

Networks change during the year, and a directory can be out of date. Confirm with the provider's office and the plan before you enroll or schedule care.

Silverpath is a licensed insurance agency. This page isn't affiliated with or endorsed by Sadia Ghafoor or their practice. Not connected with or endorsed by the U.S. government or the federal Medicare program.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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