Organization Active NPI

Alhaddad Physician Services

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1235517129
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
248285 Issued in NY
Legal business name
ALHADDAD PHYSICIAN SERVICES
Practice address
466 Bay Ridge Ave
Brooklyn, NY 11220-5906
Phone
(718) 491-2003
Fax
(718) 491-2007
NPI assigned
May 11, 2015
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Basal Alhaddad
Title
MD
Phone
(347) 733-3255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 248285 NY Primary

Addresses

Primary practice location

466 Bay Ridge Ave
Brooklyn, NY 11220-5906

Mailing address

8407 10TH Ave
Brooklyn, NY 11228-3201
Phone (347) 733-3255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150806012204 NY Part B Supplier - Clinic/Group Practice 8729392584 Receives reassigned benefits from 2 practitioners
Practice locations: Staten Island, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1235517129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8407 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283201",
            "telephone_number": "347-733-3255",
            "fax_number": "718-491-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 BAY RIDGE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205906",
            "telephone_number": "718-491-2003",
            "fax_number": "718-491-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALHADDAD PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "ALHADDAD",
        "authorized_official_first_name": "BASAL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "347-733-3255"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "248285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.