Individual provider Active NPI

Sara Waliuddin, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1720512791
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD475339 Issued in PA
Practice address
1741 Frankford Ave Ste 100a
Philadelphia, PA 19125-2445
Phone
(215) 425-2424
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD475339 PA Primary

Addresses

Primary practice location

1741 Frankford Ave Ste 100a
Philadelphia, PA 19125-2445

Mailing address

6431 Fannin St Ste JJL 308S
Houston, TX 77030-1501
Phone (713) 500-7600

Other practice location 1

2301 E Allegheny Ave Ste 150
Philadelphia, PA 19134-4427
Phone (215) 926-3535

Other practice location 2

261 Old York Rd Ste 216
Jenkintown, PA 19046-3724
Phone (215) 884-3800

Other practice location 3

11000 Roosevelt Blvd Unit 360
Philadelphia, PA 19116-3961
Phone (215) 677-1475

Other practice location 4

2118 Cottman Ave
Philadelphia, PA 19149-1133
Phone (215) 342-3020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IA2 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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220202002368 PA Practitioner - Family Practice 6800299603 Reassigns benefits to 1 organization
I20230314001336 IA Practitioner - Family Practice 6800299603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 2230
Bettendorf, IA 52722-1644
Phone (563) 742-5150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Feb 1, 2022 Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Feb 27, 2023 Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Temple Physicians Inc Family Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

3415 53rd Ave
Bettendorf, IA 52722
Phone (563) 742-4350

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

261 Old York Rd
Ste 216
Jenkintown, PA 19046
Phone (215) 884-3800

2118 Cottman Ave
Philadelphia, PA 19149
Phone (215) 342-3020

2301 E Allegheny Ave
Ste 150
Philadelphia, PA 19134
Phone (215) 926-3535

11000 Roosevelt Blvd
Unit 360
Philadelphia, PA 19116
Phone (215) 677-1475

Interoperability endpoints

  • Direct secure messaging: swaliuddin941580@direct.unitypoint.org

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 3

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1720512791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE JJL 308S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 FRANKFORD AVE STE 100A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252445",
            "telephone_number": "215-425-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 E Allegheny Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191344427",
            "country_code": "US",
            "telephone_number": "215-926-3535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "261 Old York Rd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "190463724",
            "country_code": "US",
            "telephone_number": "215-884-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11000 Roosevelt Blvd Unit 360",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191163961",
            "country_code": "US",
            "telephone_number": "215-677-1475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2118 Cottman Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191491133",
            "country_code": "US",
            "telephone_number": "215-342-3020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALIUDDIN",
        "first_name": "SARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD475339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.