Individual provider Active NPI

Tariq Hussni Ali Enezate, MD

  • Interventional Cardiology Physician
  • Columbus, IN
National Provider Identifier
1154600492
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01098160A Issued in IN
Practice address
2325 18TH St Ste 130
Columbus, IN 47201-5387
Phone
(812) 379-2020
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017-02439 NC
Interventional Cardiology Physician 207RI0011X 01098160A IN Primary
Cardiovascular Disease Physician 207RC0000X 036157953 IL
Cardiovascular Disease Physician 207RC0000X 2017-02439 NC
Internal Medicine Physician 207R00000X 2014027804 MO
Interventional Cardiology Physician 207RI0011X 2017-02439 NC
Internal Medicine Physician 207R00000X 036157953 IL
Interventional Cardiology Physician 207RI0011X 036157953 IL
Cardiovascular Disease Physician 207RC0000X 2014027804 MO

Addresses

Primary practice location

2325 18TH St Ste 130
Columbus, IN 47201-5387

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Other practice location 1

300 Keisler Dr Ste 204
Cary, NC 27518-7083
Phone (919) 233-0059

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tenezate62550@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200831000794 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 6709010937
I20211020001229 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 6709010937 Reassigns benefits to 3 organizations
I20251107000347 IN Practitioner - Interventional Cardiology 6709010937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

1405 W Park St
Urbana, IL 61801-2367
Phone (217) 337-3240

2325 18TH St
Suite 130
Columbus, IN 47201-5387
Phone (812) 379-2020

800 N Logan Ave
Suite 204
Danville, IL 61832-3741
Phone (217) 431-4080

812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014027804MOMDInternal Medicine Physician
036157953ILMDCardiovascular Disease Physician
01098160AINMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Oct 23, 2025 Accepting new patients
Columbus Regional Health Physicians, LLC Internal Medicine CurrentSince Oct 23, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Internal Medicine CurrentSince Jun 11, 2024 Accepting new patients
Blessing Hospital CurrentSince Jan 1, 2025 Accepting new patients
Blessing Hospital CurrentSince Jan 1, 2025 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1005 Broadway St
Quincy, IL 62301

1405 W Park St
Ste 303
Urbana, IL 61801
Phone (217) 337-2924

1405 W Park St
Urbana, IL 61801
Phone (217) 337-3240

2325 18th St
Ste 130
Columbus, IN 47201
Phone (812) 379-2020

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1154600492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 18TH ST STE 130",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015387",
            "telephone_number": "812-379-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Keisler Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275187083",
            "country_code": "US",
            "telephone_number": "919-233-0059",
            "fax_number": "919-233-0343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENEZATE",
        "first_name": "TARIQ",
        "middle_name": "HUSSNI ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-02439",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01098160A",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036157953",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2017-02439",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014027804",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2017-02439",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036157953",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036157953",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2014027804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tenezate62550@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "2325 18th St Ste 130",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.