Active NPI
Tarek H Elawa
- Pharmacist
- Oshkosh, WI
National Provider Identifier
1023393196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16160-40
- Practice address
- 950 S Koeller St
Oshkosh, WI 54902-6175 - Phone
- (920) 303-1712
- NPI assigned
- Oct 19, 2011
- Last updated
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16160-40 | WI | Primary |
Addresses
Primary practice location
950 S Koeller St
Oshkosh, WI 54902-6175
Mailing address
131 Wyldewood Dr
Apt # K202
Oshkosh, WI 54904-8649
Phone (414) 335-4608
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16160-40 | WI | MD | Pharmacist |
Practice roles
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1023393196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 WYLDEWOOD DR",
"address_2": "APT # K202",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549048649",
"telephone_number": "414-335-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 S KOELLER ST",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549026175",
"telephone_number": "920-303-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELAWA",
"first_name": "TAREK",
"middle_name": "H",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "16160-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.