Individual provider Active NPI

Moulaye Ahmed Haidara, M.D

  • Ophthalmology Physician
  • Arlington, TX
National Provider Identifier
1942647722
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R7219 Issued in TX
Practice address
350 E Interstate 20
Arlington, TX 76018-1119
Phone
(817) 784-0222
Fax
(817) 417-0981
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X R7219 TX Primary

Addresses

Primary practice location

350 E Interstate 20
Arlington, TX 76018-1119

Mailing address

350 E Interstate 20
Arlington, TX 76018-1119
Phone (817) 784-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180830002152 TX Practitioner - Ophthalmology 4486952694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Maryland School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arlington Ophthalmology Association PLLCGroup PAC ID 2668379876, 22 clinicians

Practice addresses (Care Compare)

2007 N Jefferson Ave
Ke Eye Centers of Texas
Mount Pleasant, TX 75455-2336
Phone (903) 572-6655

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269958MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of North Texas, PLLC PastSince May 1, 2020 Accepting new patients
Staten Island Physician Practice PC Ophthalmology Past Accepting new patients

Organizations & group practices 4

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1942647722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181119",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181119",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDARA",
        "first_name": "MOULAYE",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "R7219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.