Ahsen Ali MD PSC – Internal Medicine Physician

Key facts

NPI: 1205975554
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: 31875 (KY)
Legal business name: AHSEN ALI MD PSC
Practice address: 306 Hospital Dr Ste 2C
South Williamson, KY 41503-4095
Phone: (606) 237-4800
Fax: (606) 237-4803
NPI assigned: Feb 5, 2007
Organization subpart: No

Authorized official

Name: Dr. Ahsen Ali Butt, M.D.
Title: President
Phone: (606) 237-4800

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Ahsen Ali MD PSC Rural Health Clinic/Center · South Williamson, KY · NPI 1710656020

Same PAC ID 5193803625

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Ahsen Ali MD PSC Rural Health Clinic/Center · South Williamson, KY · NPI 1710656020

NPD tax ID
Ahsen Ali MD PSC Medical Physician Assistant · South Williamson, KY · NPI 1801130596

NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Ahsen Ali Butt, M.D. Internal Medicine Physician · Pikeville, KY · NPI 1528001633

Medicare reassignment Care Compare group NPD INTERNAL MEDICINE · KY · WV
James Arlin Stanley, APRN Family Nurse Practitioner · South Williamson, KY · NPI 1568983195

Medicare reassignment Care Compare group NPD FAMILY · KY

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in WV, KY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20080423000488	WV	Part B Supplier - Clinic/Group Practice	5193803625	Receives reassigned benefits from 1 practitioner Practice locations: Matewan, WV; Williamson, WV
O20080522000372	KY	Part B Supplier - Clinic/Group Practice	5193803625	Receives reassigned benefits from 2 practitioners Practice locations: South Williamson, KY

National Provider Directory

Tax ID family: Ahsen Ali MD PSC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X	31875	KY	Yes
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X
Rural Health Clinic/Center	261QR1300X
Family Nurse Practitioner Group: 193200000X MULTI-SPECIALTY GROUP	363LF0000X

Addresses

Primary practice location

306 Hospital Dr Ste 2C
South Williamson, KY 41503-4095

Mailing address

160 Hospital Dr
Arh Hospital
South Williamson, KY 41503-4071
Phone (606) 237-4800

Other practice location 1

160 Hospital Dr
Arh Hospital
South Williamson, KY 41503-4071
Phone (606) 237-4800

Other identifiers

Identifier	Type	State	Issuer
207518	Other		CARELINK
002038132003	Other	WV	UNITED HEALTH CARE
002038132004	Other	KY	UNITED HEALTH CARE
3519	Other		CHA HEALTH INS
64318751	Medicaid	KY
9586	Other		BLUEGRASS FAMILY
5996190	Other		AETNA
202554	Other		BLACK LUNG
137177	Other		UMWA
113278	Other		CHA
387156	Other		MAMSI

Other names

THE CLINIC Other name

Other providers in South Williamson, KY

All providers in South Williamson, KY · Internal Medicine Physician in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.