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MADINA HOUSE CLINIC INC
NPI 1639951338
Internal Medicine - Addiction Medicine in Fremont, CA

Active since October 17, 2023
43575 MISSION BLVD # 1019, FREMONT, CA 94539(510) 902-7080 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 8, 2024, Dec 12, 2023, Oct 23, 2023 and 1 more (4 updates tracked since 2023).

About Madina House Clinic Inc NPPES

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

MADINA HOUSE CLINIC INC (NPI 1639951338) is a healthcare organization registered as an addiction medicine in Fremont, California and active in the NPI registry since October 2023. The organization maintains a secondary practice location in Fremont and lists Amer Syed Raheemullah, Medical Director/president, as its authorized official.

NPPES Registry Identity

NPI1639951338
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameMADINA HOUSE CLINIC INC
Location Address43575 MISSION BLVD # 1019Fremont, CA 94539-5831
Mailing Address43575 Mission Blvd # 1019Fremont, CA 94539-5831 · (510) 902-7080
Phone(510) 902-7080
Organization SubpartNo
Authorized OfficialAmer Syed RaheemullahMedical Director/president · (510) 902-7080
Enumeration DateOctober 17, 2023
Last NPPES UpdateApril 8, 20244 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
✔ NPI 1639951338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
43575 MISSION BLVD # 1019, Fremont, CA 94539
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Secondary Practice Location 1

Location 134517 Winslow TerFremont, CA 94555-3628 · Phone (510) 902-7080

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Madina House Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Madina House Clinic Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Amer Raheemullah, MD
Addiction Medicine
NPI 1629484811
300 PASTEUR DR
Stanford, CA 94305
(650) 723-4000
✔ PECOS✔ Accepts Medicare16 mi

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

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 Madina House Clinic Inc's NPI number?

The NPI number for Madina House Clinic Inc is 1639951338. It was assigned to this organization in the NPPES registry on October 17, 2023.

Where is Madina House Clinic Inc located?

Madina House Clinic Inc is located at 43575 Mission Blvd # 1019, Fremont, CA 94539. The listed phone number is (510) 902-7080.

What is Madina House Clinic Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Is Madina House Clinic Inc enrolled in Medicare?

Yes. Madina House Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Madina House Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Addiction Medicine) reassigns their Medicare billing to Madina House Clinic Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Madina House Clinic Inc was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.