Active NPI
Tarif Bakdash, M.D.
- Neurology with Special Qualifications in Child Neurology Physician
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 58549
- Practice address
- 2195 Harrodsburg Rd FL 2
Lexington, KY 40504-3516 - Phone
- (859) 562-1868
- Fax
- (859) 257-0421
- NPI assigned
- Apr 7, 2010
- Last updated
- Nov 2, 2023
- 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 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2012014535 | MO | |
| Pediatrics Physician | 208000000X | 4301055614 | MI | |
| Pediatrics Physician | 208000000X | 12298 | MT | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 4301055614 | MI | |
| Neurology Physician | 2084N0400X | 63034 | WI | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 63034 | WI | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 24539 | MS | |
| Clinical Neurophysiology Physician | 2084N0600X | 58549 | KY | |
| Clinical Neurophysiology Physician | 2084N0600X | 63034 | WI | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 58549 | KY | Primary |
Addresses
Primary practice location
2195 Harrodsburg Rd FL 2
Lexington, KY 40504-3516
Mailing address
2195 Harrodsburg Rd FL 2
Lexington, KY 40504-3516
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | MO | TRICARE |
| P01110482 | Other | MO | RR MCR |
| 12298 | Other | MT | LICENSE |
| 192753001 | Medicaid | AR | |
| 200435170A | Medicaid | OK | |
| 05127841 | Medicaid | MS | |
| 1104141712 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12298 | MT | MD | Pharmacist |
| 58549 | KY | MD | Neurology with Special Qualifications in Child Neurology Physician |
| 4301055614 | MI | MD | Neurology with Special Qualifications in Child Neurology Physician |
| 63034 | WI | MD | Clinical Neurophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kentucky Medical Services Foundation, Inc | Pediatrics | Current | Accepting new patients |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| University of Kentucky | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Ozarks Medical Center | Neurology | Past | Accepting new patients |
| Commission for Children With Special Health Car | Past | Accepting new patients |
Locations
1900 Richmond Rd
Lexington, KY 40502
Phone (856) 266-2101
2195 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 323-2232
2195 Harrodsburg Rd
Ste 2
Lexington, KY 40504
Phone (859) 323-8082
2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800
800 Rose St
Lexington, KY 40536
Phone (859) 257-8562
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- tbakdash309247@ukhcdirect.org
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Lexington, KY
- NPI 1326091448
Pediatrics
-
- Diagnostic Radiology Physician
- Lexington, KY
- NPI 1770771974
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- Public Health or Welfare Agency
- Louisville, KY
- NPI 1831197953
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Neurology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1104141712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2195 HARRODSBURG RD FL 2",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2195 HARRODSBURG RD FL 2",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043516",
"telephone_number": "859-562-1868",
"fax_number": "859-257-0421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKDASH",
"first_name": "TARIF",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-07",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2012014535",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301055614",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MT",
"license": "12298",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MI",
"license": "4301055614",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "63034",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "WI",
"license": "63034",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MS",
"license": "24539",
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "KY",
"license": "58549",
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "WI",
"license": "63034",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "KY",
"license": "58549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P01110482",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "12298",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "192753001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200435170A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05127841",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104141712",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.