Individual provider Active NPI

Fenil Kholwadwala, M.D.

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1174058267
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.135911 Issued in OH
Practice address
2109 Hughes Dr FL 3
Toledo, OH 43606-3856
Phone
(419) 291-8154
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.135911 OH Primary

Addresses

Primary practice location

2109 Hughes Dr FL 3
Toledo, OH 43606-3856

Mailing address

4510 Dorr St # Ms 840
Toledo, OH 43615-4040
Phone (419) 383-3888

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3888

Other identifiers 1

IdentifierTypeStateIssuer
0358642MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20210603000089 NM Practitioner - Emergency Medicine 6709112097 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Jul 17, 2023 Accepting new patients

Locations

10501 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 727-2000

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1174058267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 DORR ST # MS 840",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436154040",
            "telephone_number": "419-383-3888",
            "fax_number": "419-383-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR FL 3",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063856",
            "telephone_number": "419-291-8154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3888",
            "fax_number": "419-383-2860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOLWADWALA",
        "first_name": "FENIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.135911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0358642",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.