Individual provider Active NPI

Ejaz Ahmad, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Dayton, OH
National Provider Identifier
1831158070
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35084627 Issued in OH
Practice address
2222 Philadelphia Dr
Dayton, OH 45406-1813
Phone
(937) 278-6251
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35084627 OH Primary

Addresses

Primary practice location

2222 Philadelphia Dr
Dayton, OH 45406-1813

Mailing address

PO Box 713058
Columbus, OH 43271-0001
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
2511571MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eahmad31355@lickingmemorial.medicity.net Licking Memorial Health Professionals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040817001366 OH Practitioner - Pathology 1951374933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4000

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35084627OHMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Associates of Pathology, Inc. CurrentSince Mar 18, 2017 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jan 4, 2023 Accepting new patients
Licking Memorial Professional Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jan 4, 2023 Accepting new patients
Licking Memorial Health Professionals Current Accepting new patients
Upper Valley Medical Center Past Accepting new patients
Dayton Pathology Associates, Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

5700 Southwyck Blvd
Toledo, OH 43614

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

Organizations & group practices 6

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 1

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": "1674172800000",
    "number": "1831158070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713058",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432710001",
            "telephone_number": "800-288-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 PHILADELPHIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061813",
            "telephone_number": "937-278-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "EJAZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35084627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2511571",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eahmad31355@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Health Professionals",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.