Individual provider Active NPI

Muhammad Emdadul Haque, MD

  • Pain Medicine Physician
  • New Smyrna Beach, FL
National Provider Identifier
1417905837
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME0076036 Issued in FL
Practice address
412 Palmetto Street
New Smyrna Beach, FL 32168
Phone
(386) 427-4752
Fax
(386) 426-8855
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X ME0076036 FL Primary

Addresses

Primary practice location

412 Palmetto Street
New Smyrna Beach, FL 32168

Mailing address

412 Palmetto Street
New Smyrna Beach, FL 32168
Phone (386) 427-4752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080819000318 FL Practitioner - Interventional Pain Management 3678648102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

412 Palmetto St
New Smyrna Beach, FL 32168-7361

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0076036FLMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Emdadul Haque MD PA CurrentSince Jun 15, 1999 Accepting new patients

Locations

412 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 427-4752

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1417905837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PALMETTO STREET",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-427-4752",
            "fax_number": "386-426-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PALMETTO STREET",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "32168",
            "telephone_number": "386-427-4752",
            "fax_number": "386-426-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "MUHAMMAD",
        "middle_name": "EMDADUL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME0076036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.