Individual provider Active NPI

Ahmed S Hadi, M.D.

  • Dermatology Physician
  • Glen Rock, NJ
National Provider Identifier
1831490614
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA09546000 Issued in NJ
Practice address
85 Harristown Rd Ste 101
Glen Rock, NJ 07452-3323
Phone
(201) 855-8495
Fax
(201) 621-0854
NPI assigned
Nov 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 264043 NY
Dermatology Physician 207N00000X 25MA09546000 NJ Primary

Addresses

Primary practice location

85 Harristown Rd Ste 101
Glen Rock, NJ 07452-3323

Mailing address

85 Harristown Rd Ste 101
Glen Rock, NJ 07452-3323
Phone (201) 855-8495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20141001001752 NJ Practitioner - Dermatology 8325268063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

810 River Rd
New Milford, NJ 07646-3014
Phone (201) 855-8495

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions559
Removal or shaving of skin growth1-10
Skin biopsy547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264043NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group, LLC CurrentSince Jan 15, 2018 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Jul 1, 2020 Accepting new patients
Sovereign Medical Group LLC CurrentSince Jan 15, 2018 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

85 Harristown Rd
Ste 102
Glen Rock, NJ 07452
Phone (201) 445-5161

85 Harristown Rd
Ste 101
Glen Rock, NJ 07452
Phone (201) 855-8317

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

810 River Rd
New Milford, NJ 07646
Phone (201) 855-8495

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Networks

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

Organizations & group practices 3

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": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1831490614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD STE 101",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523323",
            "telephone_number": "201-855-8495",
            "fax_number": "201-621-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD STE 101",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523323",
            "telephone_number": "201-855-8495",
            "fax_number": "201-621-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADI",
        "first_name": "AHMED",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-09",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "264043",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA09546000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

Verify at the official NPI Registry.