Individual provider Active NPI

Raza Mahmood Ahmad, MD

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1790312262
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
260639 Issued in NC
Practice address
1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5812
Phone
(704) 355-7874
Fax
(704) 355-5619
NPI assigned
Mar 25, 2020
Last updated
Mar 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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 260639 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd Ste 601
Charlotte, NC 28203-5812

Mailing address

4308 S Derbigny St
New Orleans, LA 70125-5109

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
I20260529004278 GA Order and Referring Only - Cardiac SurgeryPractitioner - Cardiac Surgery 6800217167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260639NCMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1790312262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 S DERBIGNY ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701255109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD STE 601",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-7874",
            "fax_number": "704-355-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "RAZA",
        "middle_name": "MAHMOOD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "260639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.