Organization Active NPI

Fort Health Medical Group PA

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1104690379
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FORT HEALTH MEDICAL GROUP PA
Practice address
100 S Juniper St FL 3
Philadelphia, PA 19107-1316
Phone
(201) 208-2616
NPI assigned
Nov 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Dr. Saba Haq, MD
Title
President
Phone
(949) 463-0650

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

100 S Juniper St FL 3
Philadelphia, PA 19107-1316

Mailing address

1887 Whitney Mesa Dr # 9001ZN
Henderson, NV 89014-2069
Phone (201) 208-2616

Other practice location 1

4905 W Tilghman St Ste 300
Allentown, PA 18104-9135
Phone (201) 208-2616

Other practice location 2

7244 Castor Ave # 8177
Philadelphia, PA 19149-1109
Phone (201) 208-2616

National Provider Directory

National Provider Directory
Tax ID family
Fort Health Medical Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4905 W Tilghman St
Ste 300
Allentown, PA 18104
Phone (484) 935-1512

7244 Castor Ave
#8177
Philadelphia, PA 19149

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1104690379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 WHITNEY MESA DR # 9001ZN",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142069",
            "telephone_number": "201-208-2616",
            "fax_number": "973-381-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JUNIPER ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071316",
            "telephone_number": "201-208-2616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4905 W Tilghman St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181049135",
            "country_code": "US",
            "telephone_number": "201-208-2616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7244 Castor Ave # 8177",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191491109",
            "country_code": "US",
            "telephone_number": "201-208-2616",
            "fax_number": "973-381-5773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORT HEALTH MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "HAQ",
        "authorized_official_first_name": "SABA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-463-0650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.