Individual provider Active NPI

Sally A Alwan, MD

  • Family Medicine Physician
  • Manchester, NH
National Provider Identifier
1255546115
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14402 Issued in NH
Practice address
100 Hitchcock Way
Manchester, NH 03104-4125
Phone
(603) 695-2500
NPI assigned
May 14, 2007
Last updated
Nov 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14402 NH Primary

Addresses

Primary practice location

100 Hitchcock Way
Manchester, NH 03104-4125

Mailing address

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

Other identifiers 1

IdentifierTypeStateIssuer
30209390MedicaidNH

Other names 1

  • Sally A Al-Abdulla Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000355 NH Practitioner - Family Practice 5991843708 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians
Concord Hospital IncGroup PAC ID 6103721790, 572 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

250 Pleasant St
Concord, NH 03301-2598

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 230-3138

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14402NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Medical Center CurrentSince Jan 10, 2011 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Concord Hospital, Inc. CurrentSince Sep 15, 2009 Accepting new patients
Concord Hospital, Inc. Current Accepting new patients
Catholic Medical Center CurrentSince Jan 10, 2011 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Concord Hospital, Inc. CurrentSince Sep 15, 2009 Accepting new patients
Alliance Health Services Family Medicine CurrentSince Oct 1, 2012 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

246 Pleasant St
Concord, NH 03301
Phone (603) 224-1223

246 Pleasant St
Ste 205
Concord, NH 03301
Phone (603) 224-0584

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

250 Pleasant St
Ofc
Concord, NH 03301

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

195 McGregor St
Ste 310
Manchester, NH 03102

775 S Main St
Manchester, NH 03102
Phone (603) 625-6198

Interoperability endpoints

  • Direct secure messaging: salwan98960@direct.dartmouth-hitchcock.org

Organizations & group practices 9

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 6

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1255546115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-695-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-695-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALWAN",
        "first_name": "SALLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "14402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209390",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "AL-ABDULLA",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.