Thaer Ahmad Ibrahim Abdul Hadi, MBBS, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Pensacola, FL
NPI 1831706985 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1831706985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- TRN32024 (FL)
- Practice address
- 5375 N 9TH Ave
Pensacola, FL 32504-8725 - Phone
- (850) 941-7842
- Fax
- (850) 332-0155
- NPI assigned
- Sep 23, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240129000176 | NJ | Practitioner - Hospitalist | 7416300272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN32024 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nemours New Jersey Physician Practice, P.C. | Pediatrics | Current |
Accepting new patients |
| Inspira Medical Centers, Inc. | Past | Accepting new patients | |
| Inspira Medical Centers, Inc. | Past | Accepting new patients |
Locations
700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000
1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600
1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401
Interoperability endpoints
- thaer.abdulhadi.p1@direct.cchn.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | TRN32024 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | TRN32024 | FL | Yes |
Addresses
Primary practice location
5375 N 9TH Ave
Pensacola, FL 32504-8725
Mailing address
5375 N 9TH Ave
Pensacola, FL 32504-8725
Phone (850) 941-7842
Other providers in Pensacola, FL
- Lana Abbasi
- Christen Sean Abbott
- Franklin D. Abbott Jr.
- Samantha Abbott
- Abc Medical House Calls, Inc.
- Nooshin Abedini
- Manuel Camposano Abendan
- Richard Abendan
- Staci Aberle
- Able Medical & Sickroom Supplies Inc
All providers in Pensacola, FL · Student in an Organized Health Care Education/Training Program in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.