Individual provider Active NPI

Hina Ahmad, M.D.

  • Dermatology Physician
  • Chicago, IL
National Provider Identifier
1376709154
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
125.054464 Issued in IL
Practice address
600 S Paulina St
Chicago, IL 60612-3806
Phone
(312) 942-5000
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 125.054464 IL Primary
Internal Medicine Physician 207R00000X 125.054464 IL

Addresses

Primary practice location

600 S Paulina St
Chicago, IL 60612-3806

Mailing address

417 S Jefferson St Apt 313B
Chicago, IL 60607-3819
Phone (312) 786-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130628000662 CA Practitioner - Dermatology 2062652746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rush Medical College of Rush University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision185
Removal of skin lesions45
Removal of skin cancer857
Skin biopsy34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.054464ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Jan 1, 2017 Accepting new patients
Daniel J. Wall M.D., Inc Dermatology Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

355 Lennon Ln
Ste 235
Walnut Creek, CA 94598
Phone (925) 357-9050

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

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.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1376709154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S JEFFERSON ST APT 313B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073819",
            "telephone_number": "312-786-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "HINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125.054464",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.054464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.