NPIMap

Individual provider Active NPI

Douglas Ahn, M.D.

  • Family Medicine Physician
  • Utica, NY
National Provider Identifier
1609934025
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
229831-1 Issued in NY
Practice address
6 Rhoads Dr.
Utica, NY 13502
Phone
(315) 738-7883
Fax
(315) 738-0347
NPI assigned
Dec 5, 2006
Last updated
Mar 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 229831 NY
Family Medicine Physician 207Q00000X 229831-1 NY Primary

Addresses

Primary practice location

6 Rhoads Dr.
Utica, NY 13502

Mailing address

6 Rhoads Dr.
Utica, NY 13502
Phone (315) 738-7883

Other identifiers 1

IdentifierTypeStateIssuer
02614184MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040518000540 NY Practitioner - Family Practice 8921098161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24 Kellogg Rd
New Hartford, NY 13413-2800
Phone (315) 738-7883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision40
Removal of tissue1-10
Removal of skin lesions921
Removal or shaving of skin growth76
Skin biopsy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229831NYMDFamily Medicine Physician
229831-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Ahn, M.D., P.L.L.C. Family Medicine CurrentSince Apr 2, 2007 Accepting new patients
Douglas Ahn MD PLLC Family Medicine Current Accepting new patients
Cap Medical Group PLLC Past Accepting new patients
Cap Medical, LLC Family Medicine Past Accepting new patients

Locations

24 Kellogg Rd
New Hartford, NY 13413
Phone (315) 732-1831

739 Irving Ave
Ste 510
Syracuse, NY 13210
Phone (315) 422-2999

6 Rhoads Dr
Utica, NY 13502
Phone (315) 733-0105

Organizations & group practices 4

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 10

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1609934025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 RHOADS DR.",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-738-7883",
            "fax_number": "315-738-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RHOADS DR.",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-738-7883",
            "fax_number": "315-738-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229831",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229831-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02614184",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.