Individual provider Active NPI

Waheed Syed Haque, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1942340260
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011070 Issued in NY
Practice address
173 Fort Washington Ave
New York, NY 10032-3739
Phone
(212) 305-4600
Fax
(212) 305-7439
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011070 NY Primary

Addresses

Primary practice location

173 Fort Washington Ave
New York, NY 10032-3739

Mailing address

2376 Redmond Rd
North Bellmore, NY 11710-2152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240416001191 NY Practitioner - Physician Assistant 5496194094 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011070NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Mar 10, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

173 Fort Washington Ave
New York, NY 10032
Phone (212) 305-4600

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1942340260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 REDMOND RD",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323739",
            "telephone_number": "212-305-4600",
            "fax_number": "212-305-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "WAHEED",
        "middle_name": "SYED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.