Fawad Haroon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2020013978 Issued in MO

Practice address

621 S New Ballas Rd Ste 3019B
Saint Louis, MO 63141-8267

Phone

(314) 509-5305

NPI assigned

Jul 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

Merit-based Incentive Payment System (MIPS)

Final score

82.92 of 100Reported as group

Quality

74.47

Promoting interoperability

92

Improvement activities

40

Cost

75.27

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1659989119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 3019B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 3019B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418267",
            "telephone_number": "314-509-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROON",
        "first_name": "FAWAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020013978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Susan Harms, RD
• Kim Marie Harness
• Shawna Harney, FNP
• George John Harocopos, MD
• Harold D. Wolff, Inc
• Elise Harowitz, MA, LPC, BC-DMT
• Jordan Harp, MD
• Anna Harper, PNP
• Brittany A Harper, CRNA
• Caitlyn Marguerite Harper

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.
• 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.

Verify at the official NPI Registry.