Individual provider Active NPI

Khaldon A Al Saadi, M.D.

  • Surgery Physician
  • Alma, GA
National Provider Identifier
1760433304
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
53974 Issued in GA
Practice address
204 E 15TH St
Alma, GA 31510-2908
Phone
(912) 632-0314
Fax
(912) 632-2554
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 53974 GA Primary

Addresses

Primary practice location

204 E 15TH St
Alma, GA 31510-2908

Mailing address

204 E 15TH St
Alma, GA 31510-2908
Phone (912) 632-0314

Other identifiers 1

IdentifierTypeStateIssuer
0010173800002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20171211001722 GA Practitioner - General Surgery 6103888763 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Physicians Group, LLC Surgery CurrentSince Nov 1, 2017 Accepting new patients
Orthopaedic Specialists of South Georgia Past Accepting new patients
Bacon County Health Services, Inc. Past Accepting new patients
Bacon County Health Services, Inc. Past Accepting new patients

Locations

204 E 15th St
Alma, GA 31510
Phone (912) 632-2952

205 S Wayne St
Alma, GA 31510
Phone (912) 383-9789

1406 Habersham Dr
Waycross, GA 31501
Phone (912) 287-0333

Interoperability endpoints

  • Direct secure messaging: kalsaadi@direct.excelahealth.org
  • Direct secure messaging: khaldon.alsaadi@bacon.gadirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Georgia Physicians Group, LLC 9 clinicians

Practice addresses (Care Compare)

204 E 15TH St
Alma, GA 31510-2908
Phone (912) 632-2952

Hospital & facility affiliations

  • Bacon County Hospital Hospital, Alma, GA, CCN 111327
  • Appling Healthcare Hospital, Baxley, GA, CCN 110071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux22
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1760433304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 15TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102908",
            "telephone_number": "912-632-0314",
            "fax_number": "912-632-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 15TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102908",
            "telephone_number": "912-632-0314",
            "fax_number": "912-632-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL SAADI",
        "first_name": "KHALDON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "53974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010173800002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, GA

Sources for this page

Verify at the official NPI Registry.