NPIMap

Individual provider Active NPI

Imran Ahmed, MD

  • Family Medicine Physician
  • Monticello, NY
National Provider Identifier
1043216948
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
193608 Issued in NY
Practice address
38 Concord Rd
Monticello, NY 12701-3210
Phone
(845) 333-6500
Fax
(845) 333-6501
NPI assigned
Jun 24, 2005
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 193608 NY Primary

Addresses

Primary practice location

38 Concord Rd
Monticello, NY 12701-3210

Mailing address

38 Concord Rd
Monticello, NY 12701-3210
Phone (845) 333-6500

Other practice location 1

1522 State Route 17B
White Lake, NY 12786-5428
Phone (845) 333-6600

Other identifiers 2

IdentifierTypeStateIssuer
1272374OtherNYEMPIRE UNITED HC
01494999MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061109000385 NY Practitioner - Family Practice 6305843822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193608NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Nov 21, 2022 Accepting new patients
Middletown Medical PC Family Medicine CurrentSince Nov 21, 2022 Accepting new patients
Wmop LLC Past Accepting new patients
Roscoe Regional Healthcare LLC Past Accepting new patients

Locations

111 Maltese Dr
Middletown, NY 10940

Networks

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

Interoperability endpoints

  • Direct secure messaging: imran.ahmed@mmpc.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Garnet Health Medical Center CatskillsCallicoon, NY, CCN 331303 Hospital Corporate Director Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1043216948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CONCORD RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013210",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 CONCORD RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013210",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 State Route 17B",
            "address_purpose": "LOCATION",
            "city": "White Lake",
            "state": "NY",
            "postal_code": "127865428",
            "country_code": "US",
            "telephone_number": "845-333-6600",
            "fax_number": "845-583-8084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "193608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE UNITED HC",
            "identifier": "1272374",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01494999",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

Verify at the official NPI Registry.