Individual provider Active NPI

Agha Suhail Haider, MD

  • Pulmonary Disease Physician
  • Hopewell, VA
National Provider Identifier
1730158064
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101058338 Issued in VA
Practice address
602 N 6TH Ave
Hopewell, VA 23860-2621
Phone
(804) 458-7781
Fax
(804) 458-7814
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0101058338 VA Primary

Addresses

Primary practice location

602 N 6TH Ave
Hopewell, VA 23860-2621

Mailing address

602 N 6TH Ave
Hopewell, VA 23860-2621
Phone (804) 458-7781

Other identifiers 5

IdentifierTypeStateIssuer
C05898OtherMEDICARE GROUP NUMBER
1821057639OtherVAGROUP NPI
290011273OtherVAMEDICARE RAILROAD
005819776MedicaidVA
CI3965OtherVAMEDICARE RR GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20101115000230 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8921293044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

602 N 6TH Ave
Hopewell, VA 23860-2621
Phone (804) 452-7781

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • John Randolph Medical Center Hospital, Hopewell, VA, CCN 490020
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Critical Care Associates of the Tri-Cities PC Pulmonary Disease CurrentSince Nov 16, 1998 Accepting new patients
Hopewell Gastroenterology PC PastSince Nov 16, 1998 Accepting new patients

Locations

602 N 6th Ave
Hopewell, VA 23860
Phone (804) 452-7781

603 Eppes St
Hopewell, VA 23860
Phone (804) 306-3705

261 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 835-9748

Interoperability endpoints

  • Direct secure messaging: pulmonarycriticalcareassociatesoftc.aghashaider@119905.advancedmd-direct.com

Organizations & group practices 2

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1730158064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N 6TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602621",
            "telephone_number": "804-458-7781",
            "fax_number": "804-458-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N 6TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602621",
            "telephone_number": "804-458-7781",
            "fax_number": "804-458-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "AGHA",
        "middle_name": "SUHAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101058338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C05898",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1821057639",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "290011273",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005819776",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CI3965",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.