1. Home
  2. Directory
  3. North Carolina
  4. Winston Salem
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

RAED WALEED ALI ALKHADDASH
NPI 1053983007
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since July 10, 2021PECOS Enrolled
ONE MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-7548 Get Directions Write a Review

NPPES record last updated: June 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 8, 2025, Jul 10, 2021 (2 updates tracked since 2021).

About Raed Waleed Ali Alkhaddash NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAED WALEED ALI ALKHADDASH (NPI 1053983007) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1053983007
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameRAED WALEED ALI ALKHADDASH
Location AddressONE MEDICAL CENTER BLVDWinston Salem, NC 27157-0001
Mailing AddressOne Medical Center BlvdWinston Salem, NC 27157-0001 · (336) 716-7548
Phone(336) 716-7548
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 10, 2021
Last NPPES UpdateJune 8, 20252 updates tracked since enumeration
NPPES CertifiedJune 8, 2025
✔ NPI 1053983007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
ONE MEDICAL CENTER BLVD, Winston Salem, NC 27157
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raed Waleed Ali Alkhaddash is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305249814
PECOS Enrollment IDI20260817003700
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Raed Waleed Ali Alkhaddash reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bradley Physician Services, LLC
266 mi
Orthopaedic Surgery of the Spine
2305 CHAMBLISS AVE NW
Cleveland, TN 37311
  • Reassigned Medicare billing, Tennessee enrollment
  • 88 clinicians in this Medicare group
NPI 1710727540 (423) 728-1650

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA LARUSSA MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (855) 799-0044
DR. JARED JOSEPH TUTTLE MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4091
CESAR ANDRES URIZAR-GONZALEZ MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
HOLDEN BRADLY LEWIS
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7580
HONGSHENG LU MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
PEMBROKE NASH III
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2011
IAN ALASDAIR SEDDON DO
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4490
DR. KIMBERLY ANNE WAGGENER MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4241

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raed Waleed Ali Alkhaddash's NPI number?

The NPI number for Raed Waleed Ali Alkhaddash is 1053983007. It was assigned to this individual provider in the NPPES registry on July 10, 2021.

Where is Raed Waleed Ali Alkhaddash located?

Raed Waleed Ali Alkhaddash practices at One Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-7548.

What is Raed Waleed Ali Alkhaddash's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Raed Waleed Ali Alkhaddash enrolled in Medicare?

Yes. Raed Waleed Ali Alkhaddash is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Raed Waleed Ali Alkhaddash's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raed Waleed Ali Alkhaddash reassigns Medicare benefits to Bradley Physician Services, LLC (Cleveland, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raed Waleed Ali Alkhaddash's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Raed Waleed Ali Alkhaddash was last updated on June 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.