Tarek Haidar, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

MD61404020 Issued in WA

Practice address

503 E 26TH St
Tacoma, WA 98421-1343

Phone

(253) 881-7001

Fax

(253) 881-7002

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Addiction Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revive PathwayGroup PAC ID 4284081639, 12 clinicians

Puyallup Tribal Opioid Clinic IncGroup PAC ID 4486096377, 10 clinicians

Practice addresses (Care Compare)

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.

• Puyallup Tribal Opioid Clinic, Inc.

  dba Cedar Wellness Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tacoma, WA
  • NPI 1992582613

  TX

  Medicare reassignment Care Compare group NPD
• Revive Pathway

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Cajon, CA
  • NPI 1962117440

  TX

  Medicare reassignment Care Compare group NPD
• New Life Health Authority

  dba New Life LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ukiah, CA
  • NPI 1104435734
  NPD
• Goppert - Trinity Family Care, LLC

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1922097013
  NPD (past)

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1093330599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E 26TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984211343",
            "telephone_number": "253-881-7001",
            "fax_number": "253-881-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E 26TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984211343",
            "telephone_number": "253-881-7001",
            "fax_number": "253-881-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "TAREK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD61404020",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61404020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haggen Inc (Top 41)
• Shawn Hagland, PHARMD
• Alyssa Diane Hagmann, MARR & FAM THERAPIST
• Cydni Janelle Hagstrom
• Rick Hahn, ARNP
• Ariana Michele Haidari, RD
• Sean C Hails, CP
• Yohannes Russom Haimanot
• Mark Isadore Hainer, D.O.
• Alfreda Haines, LMHC, SAP SUDP, CPC

• Addiction Medicine (Family Medicine) Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction Medicine (Family Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.