Individual provider Active NPI

Aneeza Fazli-Haq, LCSW

  • Clinical Social Worker
  • Lansdale, PA
National Provider Identifier
1871762237
Registry record updated Apr 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015769 Issued in PA
Practice address
400 N Broad St
Lansdale, PA 19446-2414
Phone
(215) 368-2022
Fax
(215) 855-6454
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW015769 PA Primary

Addresses

Primary practice location

400 N Broad St
Lansdale, PA 19446-2414

Mailing address

925 Masters Way
Harleysville, PA 19438-2186
Phone (215) 764-6788

Other identifiers 1

IdentifierTypeStateIssuer
102007451MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080410000689 PA Practitioner - Clinical Social Worker 5799862074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Muhammad Nadeem Shamsi, PCGroup PAC ID 2365575735, 6 clinicians

Practice addresses (Care Compare)

1000 Germantown Pike
Suite H4
Plymouth Meeting, PA 19462-2488
Phone (610) 275-0345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW015769PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Muhammad Nadeem Shamsi, PC. CurrentSince Aug 1, 2011 Accepting new patients

Locations

1000 Germantown Pike
Ste H4
Plymouth Mtng, PA 19462
Phone (610) 275-0345

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461369600000",
    "number": "1871762237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 MASTERS WAY",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382186",
            "telephone_number": "215-764-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462414",
            "telephone_number": "215-368-2022",
            "fax_number": "215-855-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZLI-HAQ",
        "first_name": "ANEEZA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2016-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102007451",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.