Individual provider Active NPI

Sayeeda Ahsanuddin, MD

  • Dermatology Physician
  • Fort Worth, TX
National Provider Identifier
1154857159
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
V3545 Issued in TX
Practice address
4949 Golden Triangle Blvd Ste 611
Fort Worth, TX 76244-4456
Phone
(817) 898-2188
Fax
(817) 439-6055
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35.141904 OH
Dermatology Physician 207N00000X V3545 TX Primary

Addresses

Primary practice location

4949 Golden Triangle Blvd Ste 611
Fort Worth, TX 76244-4456

Mailing address

743 E Hill St
Keller, TX 76248-2470
Phone (646) 463-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241213000685 TX Practitioner - Dermatology 0042616419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Key Dermatology PLLCGroup PAC ID 9537413414, 2 clinicians

Practice addresses (Care Compare)

4949 Golden Triangle Blvd
Suite 611
Fort Worth, TX 76244-4456
Phone (817) 898-2188

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions220
Skin biopsy146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V3545TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients
Key Dermatology PLLC Dermatology CurrentSince Dec 1, 2024 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

3516 Golden Triangle Blvd
Ste 120
Fort Worth, TX 76244
Phone (817) 898-2188

4949 Golden Triangle Blvd
Ste 611
Fort Worth, TX 76244
Phone (817) 898-2188

4949 Golden Triangle Blvd
Fort Worth, TX 76244
Phone (817) 898-2188

Interoperability endpoints

  • Direct secure messaging: sahsanuddin211093@direct.metrohealth.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1154857159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 E HILL ST",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482470",
            "telephone_number": "646-463-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 GOLDEN TRIANGLE BLVD STE 611",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444456",
            "telephone_number": "817-898-2188",
            "fax_number": "817-439-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHSANUDDIN",
        "first_name": "SAYEEDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.141904",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V3545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.