NPIMap

Individual provider Active NPI

Ali Elazab, MD

  • Internal Medicine Physician
  • Fairfield, OH
National Provider Identifier
1285169003
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.139510 Issued in OH
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 870-7000
NPI assigned
Apr 30, 2017
Last updated
Sep 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.139510 OH Primary

Addresses

Primary practice location

3000 Mack Rd
Fairfield, OH 45014-5335

Mailing address

355 Bard Ave
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200810002899 OH Practitioner - Internal Medicine 2567715683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medicine Inpatient Group LLCGroup PAC ID 3577645340, 39 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Middletown, OH 45005-2584
Phone (513) 974-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.88 of 100Reported as individual
Quality
79.43
Improvement activities
0
Cost
75.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
The Fort Hamilton Hospital Past Accepting new patients
Atrium Medical Center Past Accepting new patients
West Chester Hospital LLC Internal Medicine Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1055

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

Interoperability endpoints

  • Direct secure messaging: aelazab413520@direct.uchealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1285169003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "address_2": "DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-870-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAZAB",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-30",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.139510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.