Individual provider Active NPI

Sameer Imdad, MD

  • Pediatric Gastroenterology Physician
  • Akron, OH
National Provider Identifier
1992234348
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
35.148606 Issued in OH
Practice address
215 W Bowery St
Akron, OH 44308-1069
Phone
(330) 543-2778
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Student in an Organized Health Care Education/Training Program 390200000X 307695 NY
Pediatric Gastroenterology Physician 2080P0206X 35.148606 OH Primary

Addresses

Primary practice location

215 W Bowery St
Akron, OH 44308-1069

Mailing address

1061 Methven CT
Herndon, VA 20170-2354
Phone (703) 282-7388

Other practice location 1

101 Nicolls Rd Fl 11
Stony Brook, NY 11794-0001
Phone (631) 444-8115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170719003489 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5294005526

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307695NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron Past Accepting new patients
Children'S Hospital Medical Center of Akron Past Accepting new patients

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1992234348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 METHVEN CT",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201702354",
            "telephone_number": "703-282-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W BOWERY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081069",
            "telephone_number": "330-543-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicolls Rd Fl 11",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-8115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMDAD",
        "first_name": "SAMEER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "307695",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "35.148606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.