Individual provider Active NPI

Hamad Alabdulrazzaq, MD

  • MOHS-Micrographic Surgery Physician
  • Manchester, NH
National Provider Identifier
1881794493
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
13940 Issued in NH
Practice address
87 McGregor St
Suite 2100
Manchester, NH 03102-3765
Phone
(603) 626-7546
Fax
(603) 626-7548
NPI assigned
Sep 24, 2006
Reactivated
Sep 25, 2007
Last updated
Oct 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME96825 FL
MOHS-Micrographic Surgery Physician 207ND0101X ME96825 FL
MOHS-Micrographic Surgery Physician 207ND0101X 13940 NH Primary
MOHS-Micrographic Surgery Physician 207ND0101X 265468 MA
Pediatric Dermatology Physician 207NP0225X ME96825 FL
Procedural Dermatology Physician 207NS0135X ME96825 FL

Addresses

Primary practice location

87 McGregor St
Suite 2100
Manchester, NH 03102-3765

Mailing address

526 Main St
Suite 302
Acton, MA 01720-3301
Phone (978) 849-7507

Other identifiers 4

IdentifierTypeStateIssuer
0671642OtherFLCIGNA
58357OtherFLBLUE SHIELD
276996400MedicaidFL
304790OtherFLAVMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080303000673 NH Practitioner - Dermatology 2860491776 Reassigns benefits to 1 organization
I20160325000535 MA Practitioner - Dermatology 2860491776 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13940NHMDMOHS-Micrographic Surgery Physician
ME96825FLMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apderm North, PC Dermatology PastSince Feb 6, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: halabdulrazzaq@apderm.emadirect.md

Organizations & group practices 2

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1881794493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST",
            "address_2": "SUITE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-849-7507",
            "fax_number": "978-371-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MCGREGOR ST",
            "address_2": "SUITE 2100",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023765",
            "telephone_number": "603-626-7546",
            "fax_number": "603-626-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALABDULRAZZAQ",
        "first_name": "HAMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2016-10-07",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME96825",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME96825",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NH",
            "license": "13940",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MA",
            "license": "265468",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME96825",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME96825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0671642",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "58357",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276996400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "304790",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.