Individual provider Active NPI

Fazlul Haque, MD

  • Psychiatry Physician
  • Daphne, AL
National Provider Identifier
1831279751
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD.50770 Issued in AL
Practice address
7101 US Highway 90 Ste 103
Daphne, AL 36526-9510
Phone
(256) 701-5651
Fax
(256) 429-9411
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 191787 NY
Psychiatry Physician 2084P0800X MD.50770 AL Primary

Addresses

Primary practice location

7101 US Highway 90 Ste 103
Daphne, AL 36526-9510

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

Other practice location 1

80th St & 41st Ave
Elmhurst, NY 11373-1329
Phone (718) 334-3900

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080731000210 NY Practitioner - Psychiatry 3678647229 Reassigns benefits to 3 organizations
I20250320003333 AL Practitioner - Psychiatry 3678647229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

7101 US Hwy 90
Suite 103
Daphne, AL 36526-9510
Phone (251) 517-5800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.50770ALMDPsychiatry Physician
191787NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Jul 1, 2024 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Mar 21, 2017 Accepting new patients
Integrated Behavioral Health, Inc. Psychiatry CurrentSince Feb 27, 2025 Accepting new patients
Iop Behavioral Health, LLC PastSince Feb 27, 2025 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Locations

7101 US Highway 90
Ste 103
Daphne, AL 36526
Phone (251) 517-5800

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: fhaque842453@nychhc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1831279751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333",
            "fax_number": "256-288-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 US HIGHWAY 90 STE 103",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269510",
            "telephone_number": "256-701-5651",
            "fax_number": "256-429-9411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80th St & 41st Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "718-334-3900",
            "fax_number": "718-334-5958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "FAZLUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "191787",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.50770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

Verify at the official NPI Registry.