Active NPI
Sartaj Sultana Ahmed, M.D.
- Allergy & Immunology Physician
- Erie, PA
National Provider Identifier
1629255443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- MD434791
- Practice address
- 3546 W 12TH St
Erie, PA 16505-3654 - Phone
- (814) 879-0979
- Fax
- (814) 452-4360
- NPI assigned
- Jan 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD434791 | PA | Primary |
Addresses
Primary practice location
3546 W 12TH St
Erie, PA 16505-3654
Mailing address
3546 W 12TH St
Erie, PA 16505-3654
Phone (814) 879-0979
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 |
|---|---|---|---|---|
| I20111031000300 | PA | Practitioner - Allergy/Immunology | 9032382403 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3546 W 12TH St
Erie, PA 16505-3654
Phone (814) 879-0979
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD434791 | PA | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri State Allergy and Asthma, LLC | Current | Accepting new patients |
Locations
2409 State St
Ste D
Erie, PA 16503
3546 W 12th St
Erie, PA 16505
Phone (814) 879-0979
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566000000000",
"number": "1629255443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 W 12TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165053654",
"telephone_number": "814-879-0979",
"fax_number": "814-452-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3546 W 12TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165053654",
"telephone_number": "814-879-0979",
"fax_number": "814-452-4360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "SARTAJ",
"middle_name": "SULTANA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-23",
"last_updated": "2019-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "PA",
"license": "MD434791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2019; 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.