Active NPI
Hamza Rshaidat, MD
- Surgery Physician
- Philadelphia, PA
National Provider Identifier
1609495829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MT221081
- Practice address
- 1015 Walnut St Ste 620
Philadelphia, PA 19107-5005 - Phone
- (215) 955-6864
- Fax
- (215) 955-2878
- NPI assigned
- Apr 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | STUDENT | PA | |
| Surgery Physician | 208600000X | MT221081 | PA | Primary |
Addresses
Primary practice location
1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Mailing address
1015 Walnut Street, Suite 620
Philadelphia, PA 19107-4306
Phone (215) 955-6864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200603001637 | PA | Order and Referring Only - General Surgery | 4587085386 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| STUDENT | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591142400000",
"number": "1609495829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 WALNUT STREET, SUITE 620",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074306",
"telephone_number": "215-955-6864",
"fax_number": "215-955-2878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 WALNUT ST STE 620",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075005",
"telephone_number": "215-955-6864",
"fax_number": "215-955-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RSHAIDAT",
"first_name": "HAMZA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-09",
"last_updated": "2020-06-03",
"certification_date": "2020-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "STUDENT",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT221081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.