Individual provider Active NPI

Hassan Mirza Ahmad, M.D.

  • Anesthesiology Physician
  • Providence, RI
National Provider Identifier
1194863241
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0065862 Issued in MD
Practice address
593 Eddy St
Davol 129
Providence, RI 02903-4923
Phone
(401) 444-4933
Fax
(401) 444-5083
NPI assigned
Feb 1, 2007
Last updated
Oct 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0065862 MD Primary

Addresses

Primary practice location

593 Eddy St
Davol 129
Providence, RI 02903-4923

Mailing address

1 Virginia Ave
Suite 201
Providence, RI 02905-4427
Phone (401) 490-0916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080814000032 RI Practitioner - Anesthesiology 7214028752 Reassigns benefits to 1 organization
I20081002000235 MA Practitioner - Anesthesiology 7214028752 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albany Medical College of Union University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Anesthesia Services LLCGroup PAC ID 4082770136, 127 clinicians
Tri Anesthesia LLCGroup PAC ID 2062931215, 38 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

300 Grove St
Worcester, MA 01605-3908
Phone (781) 585-9522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0065862MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Anesthesia LLC Anesthesiology CurrentSince Apr 1, 2025 Accepting new patients
MVP Anesthesia Associates, PC Anesthesiology CurrentSince Mar 4, 2025 Accepting new patients
Icon Anesthesia Services of New England LLC Anesthesiology CurrentSince Apr 10, 2025 Accepting new patients
JJM Medical Services, PC Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients
Emergency Associates of Eastern Ohio LLC Past Accepting new patients

Locations

90 New State Hwy
Raynham, MA 02767
Phone (508) 823-7473

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

300 Grove St
Worcester, MA 01605
Phone (508) 754-0700

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1194863241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VIRGINIA AVE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054427",
            "telephone_number": "401-490-0916",
            "fax_number": "401-490-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "DAVOL 129",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4933",
            "fax_number": "401-444-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "HASSAN",
        "middle_name": "MIRZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0065862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.