NPIMap

Individual provider Active NPI

Adnan M Dahdul, MD

  • Internal Medicine Physician
  • Springfield, MA
National Provider Identifier
1104802362
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53136 Issued in MA
Practice address
819 Worcester St Ste 1
Springfield, MA 01151-1056
Phone
(413) 304-2501
Fax
(413) 789-0290
NPI assigned
Dec 20, 2005
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53136 MA Primary

Addresses

Primary practice location

819 Worcester St Ste 1
Springfield, MA 01151-1056

Mailing address

819 Worcester St Ste 1
Springfield, MA 01151-1056
Phone (413) 304-2501

Other identifiers 1

IdentifierTypeStateIssuer
3001105MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040630000460 MA Practitioner - Internal Medicine 8628065299 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Massachusetts LLC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
CH Specialty Services Ma PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Innovative Physiatry Services LLC Current Accepting new patients
Holyoke Retirement Community Inc. Past Accepting new patients
New England Rehabilitation Services of Central Massachusetts Inc Past Accepting new patients
Innovative Physician Services LLC Internal Medicine PastSince Apr 30, 2003 Accepting new patients
Encompass Health Rehabilitation Hospital of Western Massachusetts, LLC Past Accepting new patients
Hampden County Physician Associates, LLC Internal Medicine Past Accepting new patients

Locations

819 Worcester St
Ste 1
Springfield, MA 01151
Phone (337) 408-0805

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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
Vantage Health & Rehab of WestfieldWestfield, MA, CCN 225380A Skilled nursing facility Corporate Director Dec 1, 2023

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 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1104802362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-304-2501",
            "fax_number": "413-789-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-304-2501",
            "fax_number": "413-789-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHDUL",
        "first_name": "ADNAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "53136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001105",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.