NPIMap

Individual provider Active NPI

Fatema Ahmed, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1790796068
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037797E Issued in PA
Practice address
4400 Haverford Ave
Health Care Center #4
Philadelphia, PA 19104-1361
Phone
(215) 685-6769
Fax
(215) 685-6732
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD037797E PA Primary

Addresses

Primary practice location

4400 Haverford Ave
Health Care Center #4
Philadelphia, PA 19104-1361

Mailing address

500 S Broad St
Suite 360
Philadelphia, PA 19146-1613
Phone (215) 685-6769

Other identifiers 1

IdentifierTypeStateIssuer
0011277660001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000369 PA Practitioner - Internal Medicine 0941479448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercy College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

4400 Haverford Ave
Philadelphia, PA 19104-1361
Phone (215) 685-7630

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince May 28, 2011 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia CurrentSince May 28, 2011 Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

500 S Broad St
Ste 360
Philadelphia, PA 19146

4400 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7504

500 S Broad St
Philadelphia, PA 19146
Phone (215) 685-6864

1101 Market St
Fl 10
Philadelphia, PA 19107

Interoperability endpoints

  • Direct secure messaging: fatema.ahmed@pdphahs.eclinicaldirectplus.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790796068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST",
            "address_2": "SUITE 360",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461613",
            "telephone_number": "215-685-6769",
            "fax_number": "215-685-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HAVERFORD AVE",
            "address_2": "HEALTH CARE CENTER #4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041361",
            "telephone_number": "215-685-6769",
            "fax_number": "215-685-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "FATEMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037797E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011277660001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.