NPIMap

Individual provider Active NPI

M. Ahsan Ullah, M.D.

  • Nephrology Physician
  • Springfield, OH
National Provider Identifier
1275538480
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-077592 Issued in OH
Practice address
2205 N Limestone St
Springfield, OH 45503-2675
Phone
(937) 322-7521
Fax
(937) 322-4047
NPI assigned
Jun 15, 2005
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-077592 OH Primary

Addresses

Primary practice location

2205 N Limestone St
Springfield, OH 45503-2675

Mailing address

2205 N Limestone St
Springfield, OH 45503-2675
Phone (937) 322-7521

Other identifiers 1

IdentifierTypeStateIssuer
2300629MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mullah46105@direct.mercy.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040301000035 OH Practitioner - NephrologyPractitioner - Family PracticePractitioner - Internal Medicine 0941197560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Nephrology and HypertensionGroup PAC ID 3072820141, 2 clinicians

Practice addresses (Care Compare)

2205 N Limestone St
Springfield, OH 45503-2659
Phone (937) 322-7364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-077592OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Nephrology & Hypertension Nephrology CurrentSince Apr 28, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ohio Institute of Cardiac Care, Inc Internal Medicine Past Accepting new patients
Hospital Services Medical Group of Clark County Inc Internal Medicine Past Accepting new patients

Locations

2200 N Limestone St
Ste 100
Springfield, OH 45503
Phone (937) 322-1700

2200 N Limestone St
Ste 104
Springfield, OH 45503
Phone (937) 328-8933

2205 N Limestone St
Springfield, OH 45503
Phone (937) 322-7364

2205 N Limestone St
Ste 1
Springfield, OH 45503
Phone (937) 424-5986

1430 E US Highway 36
Urbana, OH 43078
Phone (937) 484-4600

Interoperability endpoints

  • Direct secure messaging: mullah46105@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1275538480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 N LIMESTONE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032675",
            "telephone_number": "937-322-7521",
            "fax_number": "937-322-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 N LIMESTONE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032675",
            "telephone_number": "937-322-7521",
            "fax_number": "937-322-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLAH",
        "first_name": "M.",
        "middle_name": "AHSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-077592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2300629",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mullah46105@direct.mercy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2205 N Limestone St",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455032675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.