Active NPI
Ali Khan Daha, M.D.
- Pain Medicine (Anesthesiology) Physician
- Lakeway, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 3510
- Practice address
- 200 Medical Pkwy Ste 210
Lakeway, TX 78738-1793 - Phone
- (512) 654-1234
- Fax
- (512) 654-0321
- NPI assigned
- Jul 13, 2011
- Last updated
- Nov 21, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 3510 | WI | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 3510 | WI | Primary |
Addresses
Primary practice location
200 Medical Pkwy Ste 210
Lakeway, TX 78738-1793
Mailing address
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
Other practice location 1
3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165
Other practice location 2
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558659490 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666
8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666
W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3510 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Anesthesiology | Current | Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
3212 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-6165
Interoperability endpoints
- adaha692727@direct.froedtert.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Anesthesiology
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Froedtert Menomonee Falls Hospital
- General Acute Care Hospital
- Menomonee Falls, WI
- NPI 1609822881
-
dba CDI-Froedtert Memorial Lutheran Hospital
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1255334173
-
dba Froedtert West Bend Hospital
- General Acute Care Hospital
- West Bend, WI
- NPI 1851336044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1558659490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 W PARADISE DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959795",
"telephone_number": "262-334-3451",
"fax_number": "262-347-3044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PKWY STE 210",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "787381793",
"telephone_number": "512-654-1234",
"fax_number": "512-654-0321"
}
],
"practiceLocations": [
{
"address_1": "3212 Pleasant Valley Rd",
"address_purpose": "LOCATION",
"city": "West Bend",
"state": "WI",
"postal_code": "530959274",
"country_code": "US",
"telephone_number": "262-334-6165",
"fax_number": "262-334-1658",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9200 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-805-8700",
"fax_number": "414-259-1522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAHA",
"first_name": "ALI",
"middle_name": "KHAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-13",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "3510",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "WI",
"license": "3510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1558659490",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.