Individual provider Active NPI

Iftikhar Ahmed, M.D.

  • Dermatopathology (Pathology) Physician
  • Phoenix, AZ
National Provider Identifier
1851376305
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
25050 Issued in AZ
Practice address
14019 S 8TH St
Phoenix, AZ 85048-4459
Phone
(480) 668-3737
NPI assigned
Dec 7, 2005
Last updated
Sep 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 36212 MN
Dermatopathology Physician 207ND0900X 25050 AZ
Dermatopathology Physician 207ND0900X 176536-1205 UT
Dermatopathology (Pathology) Physician 207ZD0900X 25050 AZ Primary

Addresses

Primary practice location

14019 S 8TH St
Phoenix, AZ 85048-4459

Mailing address

14019 S 8TH St
Phoenix, AZ 85048-4459
Phone (480) 668-3737

Other identifiers 1

IdentifierTypeStateIssuer
069817200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140821000716 AZ Practitioner - DermatologyPractitioner - PathologyPractitioner - Other (Physician) 1557433281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 S Dobson Rd
D31 D35
Chandler, AZ 85224-5694
Phone (541) 816-1049

Merit-based Incentive Payment System (MIPS)

Final score
93.76 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.19

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions147
Skin biopsy44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36212MNMDDermatopathology Physician
176536-1205UTMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brannata Wellness LLC CurrentSince May 1, 2024 Accepting new patients
Willamette Valley Toxicology Past Accepting new patients

Locations

545 SW 2nd St
Ste 201
Corvallis, OR 97333
Phone (541) 760-4775

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00332

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1851376305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14019 S 8TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850484459",
            "telephone_number": "480-668-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14019 S 8TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850484459",
            "telephone_number": "480-668-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "IFTIKHAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MN",
            "license": "36212",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AZ",
            "license": "25050",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "UT",
            "license": "176536-1205",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AZ",
            "license": "25050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069817200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.