Active NPI
Ahmad H. Ahmadi, MD
- Plastic Surgery Physician
- Sugar Land, TX
National Provider Identifier
1184620924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- L1510
- Practice address
- 1112 Soldiers Field Dr
Sugar Land, TX 77479-4001 - Phone
- (281) 265-2639
- Fax
- (281) 313-6665
- NPI assigned
- Jun 27, 2005
- Reactivated
- Apr 7, 2006
- Last updated
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | L1510 | TX | Primary |
Addresses
Primary practice location
1112 Soldiers Field Dr
Sugar Land, TX 77479-4001
Mailing address
1112 Soldiers Field Dr
Sugar Land, TX 77479-4001
Phone (281) 265-2639
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0054HX | Other | TX | BLUE CROSS BLUE SHIELD |
| 1576183-01 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1510 | TX | MD | Plastic Surgery Physician |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Plastic Surgery Physician
- Sugar Land, TX
- NPI 1417210345
-
- Ambulatory Surgical Clinic/Center
- Sugar Land, TX
- NPI 1275898041
-
- Ambulatory Surgical Clinic/Center
- Sugar Land, TX
- NPI 1356526024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1184620924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 SOLDIERS FIELD DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774794001",
"telephone_number": "281-265-2639",
"fax_number": "281-313-6665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 SOLDIERS FIELD DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774794001",
"telephone_number": "281-265-2639",
"fax_number": "281-313-6665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMADI",
"first_name": "AHMAD",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2012-06-15",
"deactivation_date": "2006-04-03",
"reactivation_date": "2006-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TX",
"license": "L1510",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0054HX",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1576183-01",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.