Individual provider Active NPI

Ali Ahsan Ali, MD

  • Psychiatry Physician
  • Poplar Bluff, MO
National Provider Identifier
1427570993
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
310218 Issued in NY
Practice address
3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone
(573) 776-9105
Fax
(573) 776-9086
NPI assigned
Jul 17, 2017
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 310218 NY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 310218 NY Primary

Addresses

Primary practice location

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573

Mailing address

7901 Broadway # C10-12
Elmhurst, NY 11373-1329

Other practice location 1

7901 Broadway # C10-12
Elmhurst, NY 11373-1329
Phone (718) 334-3542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO2 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
I20210723002926 NY Practitioner - Psychiatry 6507105053 Reassigns benefits to 2 organizations
I20260407001203 MO Practitioner - Psychiatry 6507105053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 W 72ND St
Suite LB
New York, NY 10023-3402
Phone (212) 287-5080

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Care Psychiatry PC Psychiatry CurrentSince Sep 6, 2023 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jun 15, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jun 15, 2021 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1427570993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # C10-12",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK GROVE RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011573",
            "telephone_number": "573-776-9105",
            "fax_number": "573-776-9086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Broadway # C10-12",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "718-334-3542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "ALI AHSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "310218",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "310218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.