Individual provider Active NPI

Fozan Aldulaijan, M.D.

  • Surgery Physician
  • Pittsfield, MA
National Provider Identifier
1841505369
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
244998 Issued in MA
Practice address
725 North St
Pittsfield, MA 01201-4109
Phone
(413) 881-5456
NPI assigned
Aug 9, 2010
Last updated
Aug 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 244998 MA Primary

Addresses

Primary practice location

725 North St
Pittsfield, MA 01201-4109

Mailing address

70 Lake St Apt C
Dalton, MA 01226-1386
Phone (713) 367-7414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231204001833 IA Practitioner - General Surgery 7810345717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1753 W Ridgeway Ave
Waterloo, IA 50701-4588
Phone (319) 833-6080

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3886

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)17
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244998MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Surgery CurrentSince Jan 15, 2024 Accepting new patients
Allen Memorial Hospital Corporation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1753 W Ridgeway Ave
Ste 110
Waterloo, IA 50701
Phone (319) 833-5970

Interoperability endpoints

  • Direct secure messaging: faldulaijan1029919@direct.unitypoint.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1841505369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 LAKE ST APT C",
            "city": "DALTON",
            "state": "MA",
            "postal_code": "012261386",
            "telephone_number": "713-367-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-881-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDULAIJAN",
        "first_name": "FOZAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "244998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.