Individual provider Active NPI

Bashir Abdul-Wadud, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1871510883
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057997 Issued in PA
Practice address
5 Palisades Dr Ste 100
Albany, NY 12205-6433
Phone
(518) 438-4496
Fax
(518) 438-5803
NPI assigned
Jul 16, 2006
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1876 MA
Physician Assistant 363A00000X MA057997 PA Primary

Addresses

Primary practice location

5 Palisades Dr Ste 100
Albany, NY 12205-6433

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

65 Cooper St
Innovative Physician Services, LLC
Agawam, MA 01001-2149
Phone (413) 786-8000

Other practice location 2

2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 438-4496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150929001422 NY Practitioner - Physician Assistant 2163450081 Reassigns benefits to 9 organizations
I20151204001921 PA Practitioner - Physician Assistant 2163450081 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Norton Ave
Oneonta, NY 13820-2629
Phone (607) 547-3456

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.33 of 100Reported as group
Improvement activities
40
Cost
77.32

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1876MAMDSpeech-Language Pathologist
MA057997PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Feb 1, 2020 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Apr 1, 2017 Accepting new patients
Dubois Regional Medical Center Physician Assistant CurrentSince Jun 29, 2021 Accepting new patients
Dubois Regional Medical Center CurrentSince Feb 8, 2017 Accepting new patients
Upmc Altoona CurrentSince Feb 1, 2020 Accepting new patients
New York Medical Physician Associates PC CurrentSince Feb 19, 2025 Accepting new patients
Dubois Regional Medical Center CurrentSince Feb 8, 2017 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 1, 2021 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant CurrentSince May 19, 2025 Accepting new patients
Westchester Medical Center Past Accepting new patients
Baystate Affiliated Practice Organization Medical Past Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

5 Palisades Dr
Ste 100
Albany, NY 12205
Phone (518) 438-4496

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

130 North St
Walton, NY 13856
Phone (607) 865-6541

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

100 Hospital Ave
Ofc
Dubois, PA 15801

145 Hospital Ave
Ste 204
Dubois, PA 15801
Phone (814) 371-4360

Networks

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

Interoperability endpoints

  • Direct secure messaging: babdulwadud1899226@nychhc.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 5

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1871510883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PALISADES DR STE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122056433",
            "telephone_number": "518-438-4496",
            "fax_number": "518-438-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Cooper St",
            "address_2": "Innovative Physician Services, LLC",
            "address_purpose": "LOCATION",
            "city": "Agawam",
            "state": "MA",
            "postal_code": "010012149",
            "country_code": "US",
            "telephone_number": "413-786-8000",
            "fax_number": "413-786-9788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 New Hampshire Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801764",
            "country_code": "US",
            "telephone_number": "518-438-4496",
            "fax_number": "518-438-5803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDUL-WADUD",
        "first_name": "BASHIR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1876",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.