Individual provider Active NPI

Dalia Mohammedtareq Alwasiyah, M.D.

  • Emergency Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1194088047
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2016-02272 Issued in NC
Practice address
309 Eclipse Dr
Fayetteville, NC 28311-6737
Phone
(910) 660-1897
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 210413 NC
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 210413 NC
Emergency Medicine Physician 207P00000X 2016-02272 NC Primary

Addresses

Primary practice location

309 Eclipse Dr
Fayetteville, NC 28311-6737

Mailing address

309 Eclipse Dr
Fayetteville, NC 28311-6737
Phone (910) 660-1897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220126002524 NC Practitioner - Emergency Medicine 2769738947 Reassigns benefits to 1 organization
I20240711000026 FL Practitioner - Emergency Medicine 2769738947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 596-6632

Hospital & facility affiliations

  • HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-02272NCMDEmergency Medicine Physician
210413NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoke Emergency Group, PC Multi-Specialty CurrentSince Dec 21, 2021 Accepting new patients
Emergency Medicine Services of FL, LLC Multi-Specialty CurrentSince Apr 28, 2024 Accepting new patients

Locations

11375 Cortez Blvd
Fl Oak
Brooksville, FL 34613
Phone (352) 592-2753

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: dalwasiyah96631@capefearvalley.direct-ci.com

Organizations & group practices 2

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 1

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1194088047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 ECLIPSE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283116737",
            "telephone_number": "910-660-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 ECLIPSE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283116737",
            "telephone_number": "910-660-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALWASIYAH",
        "first_name": "DALIA",
        "middle_name": "MOHAMMEDTAREQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "210413",
            "primary": false
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "NC",
            "license": "210413",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2016-02272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.