Individual provider Active NPI

Haitham Salem Abdalla Ahmed, MD, MSC, PHD

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1487175188
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
330428 Issued in NY
Practice address
920 48TH St
Brooklyn, NY 11219-2918
Phone
(718) 283-7800
Fax
(718) 635-7147
NPI assigned
Jul 3, 2017
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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 NU
Psychiatry Physician 2084P0800X MD17550 RI
Psychiatry Physician 2084P0800X 330428 NY Primary

Addresses

Primary practice location

920 48TH St
Brooklyn, NY 11219-2918

Mailing address

920 48TH St
Brooklyn, NY 11219-2918
Phone (718) 283-7800

Other practice location 1

950 Warren Ave Ste 104
East Providence, RI 02914-1432
Phone (401) 606-3711

Other practice location 2

1941 East Rd Ste 3236
Houston, TX 77054-6010
Phone (713) 486-2570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, NY2 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
I20210603002215 RI Practitioner - Psychiatry 2668871153 Reassigns benefits to 1 organization
I20240614002622 NY Practitioner - Psychiatry 2668871153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maimonides Department of Psychiatry FPPGroup PAC ID 0042115487, 34 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-8165

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Jul 22, 2024 Accepting new patients
Maimonides Department of Psychiatry FPP Psychiatry CurrentSince Jul 22, 2024 Accepting new patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Jul 30, 2021 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 30, 2021 Accepting new patients
MMC Pediatrics Faculty Practice Past Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients

Locations

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

920 48th St
Brooklyn, NY 11219
Phone (718) 283-7800

950 Warren Ave
Ste 104
East Providence, RI 02914
Phone (401) 606-0606

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

Networks

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

Organizations & group practices 7

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 1

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1487175188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192918",
            "telephone_number": "718-283-7800",
            "fax_number": "718-635-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192918",
            "telephone_number": "718-283-7800",
            "fax_number": "718-635-7147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 Warren Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029141432",
            "country_code": "US",
            "telephone_number": "401-606-3711",
            "fax_number": "401-606-3712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1941 East Rd Ste 3236",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770546010",
            "country_code": "US",
            "telephone_number": "713-486-2570",
            "fax_number": "713-486-2565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "HAITHAM",
        "middle_name": "SALEM ABDALLA",
        "name_prefix": "Dr.",
        "credential": "MD, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD17550",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "330428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.