Abdulmohsin M Ahmadjee, M.D
Individual provider Active NPI Cardiovascular Disease Physician · Appleton, WI
NPI 1225370802 · NPPES record last updated Sep 24, 2024
Key facts
- NPI
- 1225370802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 83998 (WI)
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 731-8900
- NPI assigned
- Mar 21, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Froedtert Manitowoc Medical Group, LLC
Thedacare, Incorporated
Practice addresses (Care Compare)
1414 N Taylor Dr
Sheboygan, WI 53081-1988
Phone (920) 320-2436
1650 S 41St St
Manitowoc, WI 54220-7316
Phone (920) 320-2011
1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 735-7645
2300 Western Ave
Manitowoc, WI 54220-3712
Phone (920) 320-2011
2631 Eastern Ave
Plymouth, WI 53073-4270
Phone (920) 320-2436
800 Lakefront Way
Two Rivers, WI 54241-3301
Phone (920) 320-2011
Hospital & facility affiliations
- Thedacare Regional Medical Center - Appleton Inc
- Holy Family Memorial
- Thedacare Regional Med Ctr - Neenah
- Thedacare Medical Center-Waupaca
- Thedacare Medical Center - Shawano
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 13 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240605002601 | WI | Practitioner - Cardiovascular Disease (Cardiology) |
0547585424 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83998 | WI | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Current |
Accepting new patients | |
| Froedtert Manitowoc Medical Group, LLC | Current |
Accepting new patients | |
| Thedacare Medical Center - Berlin, Inc. | Past | Accepting new patients | |
| South Lyon Health Center, Inc. | Past | Accepting new patients | |
| Thedacare Medical Center - Wild Rose, Inc | Past | Accepting new patients | |
| Thedacare Regional Medical Center-Neenah, Inc. | Past | Accepting new patients | |
| Thedacare Medical Center - New London, Inc. | Past | Accepting new patients | |
| Sparks Family Hospital Inc | Past | Accepting new patients | |
| Mt Grant General Hospital | Past | Accepting new patients |
Locations
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011
Interoperability endpoints
- aahmadjee340624@direct.thedacare.org
- aahmadjee838665@direct.froedtert.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | FA2053952 | NV | |
| Interventional Cardiology Physician | 207RI0011X | FA2053952 | NV | |
| Cardiovascular Disease Physician | 207RC0000X | 83998 | WI | Yes |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 731-8900
Other practice location 1
30 N 1900 E # 1C412
Salt Lake City, UT 84132-0002
Phone (801) 581-2401
Other providers in Appleton, WI
- Nathaniel J Agen
- Richa Aggarwal
- Lisbet Aguilar
- Rebecca J Ahlborn
- Sahar Ahmad
- Ahmed Abdirashid Ahmed
- Vicki Lynn Aho
- Hillary Marie Ahola-Jacques
- Ahp 007
- Elisa Marie Ahrens
All providers in Appleton, WI · Cardiovascular Disease Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2024. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.