Individual provider Active NPI

Genti Tahiraj, M.D.

  • Emergency Medicine Physician
  • Tupelo, MS
National Provider Identifier
1225299035
Registry record updated Jan 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21507 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(615) 477-8401
NPI assigned
Jun 24, 2008
Last updated
Jan 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2013

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 21507 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (615) 477-8401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, 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
I20110719000872 MS Practitioner - Emergency Medicine 2163615089 Reassigns benefits to 3 organizations
I20160223000579 FL Practitioner - Emergency Medicine 2163615089 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21507MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Apr 28, 2015 Accepting new patients
United Emergency Services, Inc. Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Apr 28, 2015 Accepting new patients
Turnstone Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

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

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

2025 Indian Rocks Rd S
Largo, FL 33774
Phone (727) 581-9474

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

3065 James L Redman Pkwy
Plant City, FL 33566
Phone (813) 759-4900

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

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

12530 US Highway 301 S
Riverview, FL 33578
Phone (813) 413-3888

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

150 Reynoir St
Biloxi, MS 39530
Phone (228) 284-2389

100 Hospital St
Booneville, MS 38829
Phone (662) 720-5000

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: genti_tahiraj_md_er@yourcarecommunity.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359158400000",
    "number": "1225299035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "615-477-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "615-477-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHIRAJ",
        "first_name": "GENTI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2013-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "21507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.