Individual provider Active NPI

Eliyahu Hemo, M.D.

  • Surgery Physician
  • Malvern, AR
National Provider Identifier
1255627824
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E10499 Issued in AR
Practice address
1002 Schneider Dr Ste 102
Malvern, AR 72104-4823
Phone
(501) 332-1012
Fax
(501) 332-7074
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E10499 AR Primary

Addresses

Primary practice location

1002 Schneider Dr Ste 102
Malvern, AR 72104-4823

Mailing address

1002 Schneider Dr Ste 102
Malvern, AR 72104-4823
Phone (501) 332-1012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, 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
I20170819000026 AR Practitioner - General Surgery 7517277627 Reassigns benefits to 3 organizations
I20230308000358 FL Practitioner - General Surgery 7517277627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Okaloosa Clinic CorpGroup PAC ID 0244205565, 27 clinicians

Practice addresses (Care Compare)

151 E Redstone Ave
Crestview, FL 32539-5352
Phone (850) 689-8100

524 W James Lee Blvd
Crestview, FL 32536-5129
Phone (850) 398-8725

550 Redstone Ave W
Suite 490
Crestview, FL 32536-6457
Phone (850) 689-8321

550 Redstone W Ave
Crestview, FL 32536-6457

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy54
Hernia repair (minimally invasive)11
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux50
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E10499ARMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Okaloosa Clinic Corp CurrentSince Apr 1, 2023 Accepting new patients
Ess of Fordyce LLC CurrentSince Nov 30, 2022 Accepting new patients
South Arkansas Physician Services LLC CurrentSince May 1, 2022 Accepting new patients
Arkansas Health Group Surgery CurrentSince Aug 1, 2017 Accepting new patients
Arkansas Health Group Surgery CurrentSince Aug 1, 2017 Accepting new patients
North Okaloosa Clinic Corp CurrentSince Apr 1, 2023 Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Nov 30, 2022 Accepting new patients

Locations

620 W Grove St
Ste 202
El Dorado, AR 71730
Phone (870) 863-2420

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

1002 Schneider Dr
Ste 102
Malvern, AR 72104
Phone (501) 202-7587

1002 Schneider Dr
Ste 103
Malvern, AR 72104
Phone (501) 332-1012

550 Redstone Ave W
Ste 410
Crestview, FL 32536
Phone (850) 306-2188

400 Redstone Ave W
Crestview, FL 32536
Phone (850) 683-1555

1507 Merchants Way
Ste A
Niceville, FL 32578
Phone (850) 897-3600

330 Franklin Rd
Ste 135A
Brentwood, TN 37027
Phone (615) 727-0177

Interoperability endpoints

  • Direct secure messaging: eliyahu.hemo.1@1523.direct.athenahealth.com

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 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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255627824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR STE 102",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044823",
            "telephone_number": "501-332-1012",
            "fax_number": "501-332-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR STE 102",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044823",
            "telephone_number": "501-332-1012",
            "fax_number": "501-332-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMO",
        "first_name": "ELIYAHU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E10499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.