Active NPI
Fort Health Medical Group PA
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1104690379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Pediatrics Physician | 208000000X | Primary | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Psychiatric/Mental Health Nurse Practitioner | 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 Group
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Child & Adolescent Psychiatry Physician
- Charlotte, NC
- NPI 1114766284
-
- Child & Adolescent Psychiatry Physician
- New York, NY
- NPI 1114789005
-
- Child & Adolescent Psychiatry Physician
- New York, NY
- NPI 1184341117
-
- Child & Adolescent Psychiatry Physician
- Springfield, IL
- NPI 1972342046
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.