Individual provider Active NPI

Abdul Waheed, MD

  • Cardiovascular Disease Physician
  • Elmira, NY
National Provider Identifier
1386755478
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
119700-1 Issued in NY
Practice address
200 Madison Ave
Suite 2B
Elmira, NY 14901-3218
Phone
(607) 733-4681
Fax
(607) 733-1729
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 119700-1 NY Primary

Addresses

Primary practice location

200 Madison Ave
Suite 2B
Elmira, NY 14901-3218

Mailing address

722 W Water St
Elmira, NY 14905-2435
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
01447929MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080325000088 NY Practitioner - Cardiovascular Disease (Cardiology) 5395734214 Reassigns benefits to 1 organization
I20130528000483 PA Practitioner - Cardiovascular Disease (Cardiology) 5395734214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119700-1NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince May 17, 2013 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. Cardiovascular Disease CurrentSince Jul 6, 2013 Accepting new patients
Guthrie Medical Group, P.C. Cardiovascular Disease CurrentSince May 17, 2013 Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Chemung Medical Services PC Cardiovascular Disease Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: awaheed45667@direct-guthrie.org
  • Direct secure messaging: abdul.waheed.1@17620.direct.athenahealth.com

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1386755478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2050",
            "fax_number": "607-271-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MADISON AVE",
            "address_2": "SUITE 2B",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013218",
            "telephone_number": "607-733-4681",
            "fax_number": "607-733-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHEED",
        "first_name": "ABDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "119700-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.