Individual provider Active NPI

Hadeel Alatrash Haddad, M.D.

  • Pediatric Gastroenterology Physician
  • Orlando, FL
National Provider Identifier
1164764452
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME127471 Issued in FL
Practice address
13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone
(407) 567-4000
Fax
(407) 567-5924
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME127471 FL Primary

Addresses

Primary practice location

13535 Nemours Pkwy
Orlando, FL 32827-7402

Mailing address

PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 2

IdentifierTypeStateIssuer
11647644752MedicaidDE
018114600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161207001678 FL Practitioner - Gastroenterology 4082900121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME127471FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Oct 3, 2016 Accepting new patients
The Nemours Foundation CurrentSince Oct 3, 2016 Accepting new patients
The Nemours Foundation Current Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

Interoperability endpoints

  • Direct secure messaging: halatrash44131@direct.nemours.org

Organizations & group practices 3

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1164764452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277402",
            "telephone_number": "407-567-4000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "HADEEL",
        "middle_name": "ALATRASH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME127471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11647644752",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018114600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.