Active NPI
Sally Jasmine Haas, MD
- Neonatal-Perinatal Medicine Physician
- Orange, CA
National Provider Identifier
1245418201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- A83214
- Practice address
- 1201 W la Veta Ave
Orange, CA 92868-4203 - Phone
- (714) 509-3096
- Fax
- (714) 509-7800
- NPI assigned
- Feb 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD440806 | PA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | P0059 | TX | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 37988 | AZ | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | A83214 | CA | Primary |
Addresses
Primary practice location
1201 W la Veta Ave
Orange, CA 92868-4203
Mailing address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-3096
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331284 | Medicaid | AZ |
Other names 1
- Sally Jasmine Ahmed
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A83214 | CA | MD | Neonatal-Perinatal Medicine Physician |
| MD440806 | PA | MD | Neonatal-Perinatal Medicine Physician |
| P0059 | TX | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Magella Medical Associates Billing, Inc. | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Neonatal-Perinatal Medicine Physician
- Round Rock, TX
- NPI 1083631071
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Fullerton, CA
- NPI 1336556059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623456000000",
"number": "1245418201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-3096",
"fax_number": "714-509-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-3096",
"fax_number": "714-509-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "SALLY",
"middle_name": "JASMINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-01",
"last_updated": "2021-06-12",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "PA",
"license": "MD440806",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "TX",
"license": "P0059",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "AZ",
"license": "37988",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "A83214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "331284",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SALLY",
"last_name": "AHMED",
"middle_name": "JASMINE",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.