Individual provider Active NPI

Fadi Haddad, MD

  • Surgery Physician
  • Bloomington, IN
National Provider Identifier
1932194511
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01051484A Issued in IN
Practice address
822 W 1St St
Suite 8
Bloomington, IN 47403-2384
Phone
(812) 331-8168
Fax
(812) 331-1096
NPI assigned
Sep 20, 2005
Last updated
Apr 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01051484A IN Primary

Addresses

Primary practice location

822 W 1St St
Suite 8
Bloomington, IN 47403-2384

Mailing address

822 W 1St St
Suite 8
Bloomington, IN 47403-2384
Phone (812) 331-8168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20031204000314 IN Practitioner - General Surgery 4981509817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

490 S Landmark Ave
Bloomington, IN 47403-5000
Phone (812) 336-7407

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.56 of 100Reported as individual
Quality
66.96
Promoting interoperability
57
Improvement activities
40
Cost
80.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)17
Mastectomy49
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Bloomington, PC Surgery CurrentSince Jul 1, 2006 Accepting new patients
James Bradley Ray MD PC Surgery Past Accepting new patients
James Bradley Ray, MD PC PastSince Feb 1, 2000 Accepting new patients

Locations

490 S Landmark Ave
Bloomington, IN 47403
Phone (812) 336-7407

822 W 1st St
Ste 8
Bloomington, IN 47403
Phone (812) 336-7407

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7727/brand/1/csg/1/fhir/r4

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.

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1932194511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 W 1ST ST",
            "address_2": "SUITE 8",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032384",
            "telephone_number": "812-331-8168",
            "fax_number": "812-331-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 W 1ST ST",
            "address_2": "SUITE 8",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032384",
            "telephone_number": "812-331-8168",
            "fax_number": "812-331-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "FADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01051484A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.