Active NPI
Fozan Aldulaijan, M.D.
- Surgery Physician
- Pittsfield, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 244998
- Practice address
- 725 North St
Pittsfield, MA 01201-4109 - Phone
- (413) 881-5456
- NPI assigned
- Aug 9, 2010
- Last updated
- Aug 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 17 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 244998 | MA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke's Methodist Hospital | Current | Accepting new patients | |
| Iowa Physicians Clinic Medical Foundation | Surgery | Current | 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
- 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.
-
dba UnityPoint Clinic
- General Practice Physician
- West Des Moines, IA
- NPI 1366425274
Surgery
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
dba Allen Hospital
- General Acute Care Hospital
- Waterloo, IA
- NPI 1336231091
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Allen Hospital
- General Acute Care Hospital
- Waterloo, IA
- NPI 1336231091
-
dba MercyOne Waterloo Medical Center
- General Acute Care Hospital
- Waterloo, IA
- NPI 1700827896
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.