NPIMap

Individual provider Active NPI

Abdul Haseeb, MD

  • Nephrology Physician
  • Macon, GA
National Provider Identifier
1548754856
Registry record updated Jul 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
93031 Issued in GA
Practice address
890 2ND St Ste 201
Macon, GA 31201-6863
Phone
(478) 745-4322
Fax
(478) 254-3629
NPI assigned
Jun 20, 2018
Last updated
Jul 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X 93031 GA Primary

Addresses

Primary practice location

890 2ND St Ste 201
Macon, GA 31201-6863

Mailing address

890 2ND St Ste 201
Macon, GA 31201-6863
Phone (478) 745-4322

Other practice location 1

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230511000816 GA Practitioner - NephrologyPractitioner - Internal Medicine 8527316751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Georgia Kidney Specialists, PCGroup PAC ID 7810885506, 8 clinicians

Practice addresses (Care Compare)

890 2ND St
Suite 201
Macon, GA 31201-6863
Phone (478) 745-4322

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Kidney Specialists, PC CurrentSince May 1, 2023 Accepting new patients

Locations

657 Hemlock St
Ste 200
Macon, GA 31201
Phone (478) 254-7353

745 Pine St
Macon, GA 31201
Phone (478) 476-0196

890 2nd St
Ste 201
Macon, GA 31201
Phone (478) 745-7322

1520 N Columbia St
Ste 101
Milledgeville, GA 31061

Interoperability endpoints

  • Direct secure messaging: ahaseeb1233711@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: ahaseeb146203@direct.phhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JIFEAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1548754856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 2ND ST STE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322",
            "fax_number": "478-254-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 2ND ST STE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322",
            "fax_number": "478-254-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067061253",
            "country_code": "US",
            "telephone_number": "203-709-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASEEB",
        "first_name": "ABDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "93031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.