Individual provider Active NPI

Tarek El Masri, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1194919902
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42916 Issued in KY
Practice address
9150 W Indian School Rd
Phoenix, AZ 85037-2384
Phone
(623) 931-3028
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42916 KY Primary

Addresses

Primary practice location

9150 W Indian School Rd
Phoenix, AZ 85037-2384

Mailing address

9150 W Indian School Rd
Phoenix, AZ 85037-2384
Phone (623) 931-3028

Other identifiers 1

IdentifierTypeStateIssuer
7100077010MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20151027003366 KY Practitioner - Pediatric Medicine 4981834538 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42916KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leitchfield Pediatric Clinic P.S.C. Pediatrics CurrentSince Oct 8, 2015 Accepting new patients
Community Medical Associates, Inc. CurrentSince Dec 14, 2018 Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics CurrentSince Feb 16, 2020 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Dec 14, 2018 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Feb 16, 2020 Accepting new patients
Banner Estrella Medical Center Past Accepting new patients
North Scottsdale Pediatric Associates Pediatrics Past Accepting new patients
Arbor Medical Partners, LLC Pediatrics Past Accepting new patients
Banner Gateway Medical Center Past Accepting new patients

Locations

901 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-5641

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

7926 Preston Hwy
Ste 210
Louisville, KY 40219
Phone (502) 309-9811

Interoperability endpoints

  • Direct secure messaging: telmasri152223@direct.nortonhealthcare.org
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61385
  • Direct secure messaging: tarek.elmasri@pediatricclinic.directbygreenway.com

Organizations & group practices 10

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1194919902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850372384",
            "telephone_number": "623-931-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850372384",
            "telephone_number": "623-931-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL MASRI",
        "first_name": "TAREK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "42916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100077010",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.