Theodoros Hailu, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME0089942 Issued in FL

Practice address

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503

Phone

(954) 730-2750

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Duval Emergency Group LLC

  • Emergency Medicine Physician
  • North Miami Beach, FL
  • NPI 1053645465
  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  FL

  Medicare reassignment NPD
• FMC Emergency Solutions LLC

  • Emergency Medicine Physician
  • Lauderdale Lakes, FL
  • NPI 1255435475
  NPD (past)
• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767
  NPD (past)
• Public Health Trust of Miami Dade County Florida

  • Emergency Medical Services (Emergency Medicine) Physician
  • North Miami Beach, FL
  • NPI 1578690236
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1003880774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863481",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863481",
            "telephone_number": "800-514-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131503",
            "telephone_number": "954-730-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILU",
        "first_name": "THEODOROS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0089942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270988100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50653",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00290620",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guidewell Sanitas I, LLC
• Guillaume Group, LLC (Sunrise Homemaker and Companion Services)
• Natalya T Gutierrez
• H Care DME LLC
• Habla Conmigo Speech Therapy Services, LLC
• Hair Is in Salon, Spa & Boutique LLC
• Mohammad Hajianpour, M.D.
• Samantha Marie Hallahan, MS, BCBA
• Johnniya Hamilton
• Nishayla Jenae Hamilton

• Emergency Medicine Physician in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.