Individual provider Active NPI

Emad Al Haj Ali, MD

  • Otolaryngology Physician
  • Brighton, MA
National Provider Identifier
1700340932
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
278166 Issued in MA
Practice address
736 Cambridge St
St. Margaret Center. 8TH Floor
Brighton, MA 02135
Phone
(617) 779-6441
NPI assigned
Jan 22, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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 1

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

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLC 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

4300 University Pkwy
Evans, GA 30809-3063
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WV2 enrollments
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.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20210520000292 GA Practitioner - Otolaryngology 9133528334 Reassigns benefits to 2 organizations
I20221118000501 WV Practitioner - OtolaryngologyPractitioner - Endocrinology 9133528334

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278166MAMDOtolaryngology Physician
316535NYMDGeneral Practice Physician
35.141451OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Point Pleasant Physician Billing Services General Practice CurrentSince Nov 1, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2520 Valley Dr
Ste 113
Pt Pleasant, WV 25550
Phone (304) 675-1020

2520 Valley Dr
Pt Pleasant, WV 25550
Phone (304) 675-1020

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 316535 NY
General Practice Physician 208D00000X 93301 GA
General Practice Physician 208D00000X 31732 WV
General Practice Physician 208D00000X 35.141451 OH
Otolaryngology Physician 207Y00000X 278166 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

736 Cambridge St
St. Margaret Center. 8TH Floor
Brighton, MA 02135

Mailing address

35423 Hickory Green CT Apt B
Westland, MI 48185-6674
Phone (469) 767-1748

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 7, 2022.

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1700340932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35423 HICKORY GREEN CT APT B",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481856674",
            "telephone_number": "469-767-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "ST. MARGARET CENTER. 8TH FLOOR",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-779-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL HAJ ALI",
        "first_name": "EMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "316535",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "93301",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "31732",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35.141451",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "278166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.