Individual provider Active NPI

Sameer Ahmed, MD

  • Vascular & Interventional Radiology Physician
  • New Haven, CT
National Provider Identifier
1104191444
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036.142379 Issued in IL
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-5555
Fax
(203) 688-4516
NPI assigned
Mar 20, 2012
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036.142379 IL
Student in an Organized Health Care Education/Training Program 390200000X
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X 036.142379 IL Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

333 Cedar St
PO Box 208030
New Haven, CT 06510-3206
Phone (203) 688-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180619003294 IL Practitioner - Interventional Radiology 7810138245 Reassigns benefits to 3 organizations
I20240813002256 MI Practitioner - Vascular Surgery 7810138245 Reassigns benefits to 1 organization
I20260223001975 TX Practitioner - Interventional Radiology 7810138245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Johns Hopkins University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians
Insight Chicago IncGroup PAC ID 2860894706, 140 clinicians
Pain and Vascular Institute PLLCGroup PAC ID 9931617495, 2 clinicians

Practice addresses (Care Compare)

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (708) 382-1498

4800 S Saginaw St
Flint, MI 48507-2677

912 Northwest Hwy
Suite 102
Fox River Grove, IL 60021-1925
Phone (224) 357-4001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal15
Leg revascularization (restoring blood flow)40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142379ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah MD PC CurrentSince Aug 1, 2024 Accepting new patients
Insight Chicago, Inc. CurrentSince Feb 4, 2022 Accepting new patients
David P Ellent PLLC Single Specialty CurrentSince Jan 6, 2026 Accepting new patients
Friedell Clinic, S. C. Single Specialty CurrentSince Jun 5, 2019 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Pain & Vascular Institute PLLC Single Specialty CurrentSince Oct 3, 2025 Accepting new patients
Jackson Park Hospital Foundation Single Specialty Current Accepting new patients
Insight Chicago, Inc. Single Specialty CurrentSince Feb 4, 2022 Accepting new patients
David P Ellent PLLC CurrentSince Jan 6, 2026 Accepting new patients
Jawad a Shah, MD PC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Insight Chicago, Inc. Past Accepting new patients

Locations

190 E Delaware Pl
Chicago, IL 60611
Phone (312) 944-0063

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

912 Northwest Hwy
Ste 102
Fox River Grv, IL 60021
Phone (224) 357-4001

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

2610 W Sam Houston Pkwy S
Houston, TX 77042
Phone (713) 360-8181

22751 Professional Dr
Ste 140
Kingwood, TX 77339
Phone (281) 319-8380

135 Vision Park Blvd
Shenandoah, TX 77384
Phone (281) 404-3000

2255 E Mossy Oaks Rd
Ste 500
Spring, TX 77389

9303 Pinecroft Dr
Ste 340
The Woodlands, TX 77380
Phone (281) 681-0616

24721 State Highway 249
Tomball, TX 77375
Phone (281) 205-3681

26940 Kuykendahl Rd
Ste 200
Tomball, TX 77375
Phone (281) 357-5515

Interoperability endpoints

  • Direct secure messaging: sahmed95919@direct.luhs.org
  • Direct secure messaging: sameer.ahmed.1@33614.direct.athenahealth.com
  • Direct secure messaging: sameerahmed@jph.medalliesdirect.net

Organizations & group practices 11

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 3

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1104191444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "address_2": "PO BOX 208030",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-688-5555",
            "fax_number": "203-688-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-5555",
            "fax_number": "203-688-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "SAMEER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.142379",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.142379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.