Individual provider Active NPI

Syed W. Haque, M.D.

  • Internal Medicine Physician
  • Frederick, MD
National Provider Identifier
1952390205
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0054636 Issued in MD
Practice address
700 Montclaire Avenue
Frederick, MD 21701-4509
Phone
(301) 662-5252
Fax
(301) 662-6943
NPI assigned
Oct 19, 2005
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0054636 MD Primary

Addresses

Primary practice location

700 Montclaire Avenue
Frederick, MD 21701-4509

Mailing address

700 Montclaire Avenue
Frederick, MD 21701
Phone (301) 663-5252

Other identifiers 2

IdentifierTypeStateIssuer
110228878OtherMDRR MEDICARE
024500300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20070907000370 MD Practitioner - Internal Medicine 9537252556 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Syed Wasimul Haque Mdpa Internal Medicine CurrentSince May 6, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

700 Montclaire Ave
Frederick, MD 21701
Phone (301) 663-5252

Interoperability endpoints

  • Direct secure messaging: syed.haque.1@20939.direct.athenahealth.com

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1952390205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MONTCLAIRE AVENUE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "301-663-5252",
            "fax_number": "301-662-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MONTCLAIRE AVENUE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014509",
            "telephone_number": "301-662-5252",
            "fax_number": "301-662-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "SYED",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0054636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110228878",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024500300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.