Individual provider Active NPI

Ahmad S Jallad

  • Family Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1710466057
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
023083 Issued in OH
Practice address
5651 Elliott Dr.
Sylvania, OH 43560-4356
Phone
(718) 300-0318
NPI assigned
Aug 8, 2018
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 023083 OH Primary

Addresses

Primary practice location

5651 Elliott Dr.
Sylvania, OH 43560-4356

Mailing address

5651 Elliott Dr
Sylvania, OH 43560-2064
Phone (718) 300-0318

Other practice location 1

3231 Manley Rd
Maumee, OH 43537-9680
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191104000108 OH Practitioner - Nurse Practitioner 8921330416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

3600 Butz Rd
Maumee, OH 43537-9691
Phone (731) 394-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
023083OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Nov 11, 2019 Accepting new patients
Signify Health, LLC CurrentSince Nov 1, 2021 Accepting new patients
Ultra Health LLC CurrentSince Jan 17, 2025 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

L2540
Columbus, OH 43260

3231 Manley Rd
Maumee, OH 43537
Phone (419) 865-1248

3600 Butz Rd
Maumee, OH 43537
Phone (419) 867-7926

10540 Fremont Pike
Perrysburg, OH 43551
Phone (419) 874-3578

1011 N Byrne Rd
Toledo, OH 43607
Phone (419) 536-7600

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1710466057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 ELLIOTT DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602064",
            "telephone_number": "718-300-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 ELLIOTT DR.",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435604356",
            "telephone_number": "718-300-0318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 Manley Rd",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435379680",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JALLAD",
        "first_name": "AHMAD",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "023083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.