Individual provider Active NPI

Ahsan H Kathawala, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1962453225
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000028245 Issued in TN
Practice address
1264 Wesley Dr
Suite 501
Memphis, TN 38116-6400
Phone
(901) 346-1800
Fax
(901) 346-0043
NPI assigned
May 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MD0000028245 TN Primary

Addresses

Primary practice location

1264 Wesley Dr
Suite 501
Memphis, TN 38116-6400

Mailing address

PO Box 383317
Germantown, TN 38183-3317
Phone (901) 346-1800

Other identifiers 8

IdentifierTypeStateIssuer
0118459MedicaidMS
3804749MedicaidTN
0441108OtherUNITED HEALTHCARE
3027560OtherAETNA
8394237OtherCIGNA
000000115782OtherUNISON HEALTH PLAN
4028944OtherBCBST
5009811OtherTLC FAMILY CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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
I20110202000070 TN Practitioner - Internal Medicine 1759307523 Reassigns benefits to 2 organizations
I20150304001298 MS Practitioner - Internal Medicine 1759307523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consolidated Medical Practices of Memphis,PLLCGroup PAC ID 1759459845, 113 clinicians

Practice addresses (Care Compare)

6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000028245TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Medical Inc. Internal Medicine CurrentSince Jan 1, 1999 Accepting new patients
Consolidated Medical Practices of Memphis,PLLC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Deepika R Pulusani, MD, PC Past Accepting new patients

Locations

7163 Goodman Rd
Olive Branch, MS 38654
Phone (662) 874-6507

1264 Wesley Dr
Ste 302
Memphis, TN 38116
Phone (901) 260-2072

1264 Wesley Dr
Ste 501
Memphis, TN 38116
Phone (901) 346-1800

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962453225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383317",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381833317",
            "telephone_number": "901-346-1800",
            "fax_number": "901-346-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 WESLEY DR",
            "address_2": "SUITE 501",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166400",
            "telephone_number": "901-346-1800",
            "fax_number": "901-346-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHAWALA",
        "first_name": "AHSAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000028245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118459",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3804749",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0441108",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3027560",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8394237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "000000115782",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4028944",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC FAMILY CARE",
            "identifier": "5009811",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.