Individual provider Active NPI

Anwar Mohammed Haque, MD

  • Pulmonary Disease Physician
  • Willingboro, NJ
National Provider Identifier
1689833402
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MA08914200 Issued in NJ
Practice address
218C Sunset Rd
Willingboro, NJ 08046-1104
Phone
(609) 877-0400
Fax
(609) 877-1682
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X MA08914200 NJ Primary
Pulmonary Disease Physician 207RP1001X 251151 NY

Addresses

Primary practice location

218C Sunset Rd
Willingboro, NJ 08046-1104

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 342-2000

Other practice location 1

5 Palisades Dr Ste 100
Albany, NY 12205-6433
Phone (518) 438-4496

Other identifiers 1

IdentifierTypeStateIssuer
MA08914200OtherNJMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20091026000162 NY Practitioner - Pulmonary Disease 7416094362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Palisades Dr
Suite 100
Albany, NY 12205-6433
Phone (518) 438-4496

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA08914200NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Pulmonary Disease CurrentSince Jul 15, 2014 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. CurrentSince Jul 15, 2014 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

5 Palisades Dr
Ste 100
Albany, NY 12205
Phone (518) 438-4496

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: ahaque788830@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1689833402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2000",
            "fax_number": "609-877-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218C SUNSET RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461104",
            "telephone_number": "609-877-0400",
            "fax_number": "609-877-1682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Palisades Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122056433",
            "country_code": "US",
            "telephone_number": "518-438-4496",
            "fax_number": "518-438-5803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "ANWAR",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "MA08914200",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "251151",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA08914200",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5 Palisades Dr Ste 100",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122056433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.