Individual provider Active NPI

Rishi Tejas Dholakia, DO, MPH

  • Surgery Physician
  • Winslow, AZ
National Provider Identifier
1083807184
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
008337 Issued in AZ
Practice address
500 Indiana Ave
Winslow, AZ 86047-2169
Phone
(928) 289-4646
NPI assigned
Aug 22, 2007
Last updated
May 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 295701 NY
Surgery Physician 208600000X DO179438 OR
Surgery Physician 208600000X P 6376 TX
Surgery Physician 208600000X 20A 11963 CA
Surgery Physician 208600000X 008337 AZ Primary

Addresses

Primary practice location

500 Indiana Ave
Winslow, AZ 86047-2169

Mailing address

500 Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

Other practice location 1

Dept of Surgery, Health Sciences Tower
T-19, Room 053
Stony Brook, NY 11794-8191
Phone (631) 444-8330

Other practice location 2

Dept Of Surgery Health Sciences Tower T-19, Room 053
Stony Brook, NY 11794
Phone (631) 444-8330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140326001775 TX Practitioner - General Surgery 3577715192 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008337AZMDSurgery Physician
20A 11963CAMDSurgery Physician
295701NYMDSurgery Physician
DO179438ORMDSurgery Physician
P 6376TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Winslow Indian Health Care Group CurrentSince Jan 27, 2020 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Jan 27, 2020 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Aug 15, 2023 Accepting new patients

Locations

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

Organizations & group practices 5

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1083807184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Dept of Surgery, Health Sciences Tower",
            "address_2": "T-19, Room 053",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948191",
            "country_code": "US",
            "telephone_number": "631-444-8330",
            "fax_number": "631-638-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Dept Of Surgery Health Sciences Tower T-19, Room 053",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "11794",
            "country_code": "US",
            "telephone_number": "631-444-8330",
            "fax_number": "631-638-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHOLAKIA",
        "first_name": "RISHI",
        "middle_name": "TEJAS",
        "name_prefix": "Dr.",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "295701",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "DO179438",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P 6376",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A 11963",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "008337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.