Individual provider Active NPI

Elizabeth Tenaglia Azel, MD

  • Family Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1396794392
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48300 Issued in TN
Practice address
100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone
(865) 482-1777
Fax
(865) 482-1030
NPI assigned
May 8, 2006
Last updated
Sep 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48300 TN Primary

Addresses

Primary practice location

100 Vermont Ave
Oak Ridge, TN 37830-6471

Mailing address

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

Other identifiers 1

IdentifierTypeStateIssuer
Q005627MedicaidTN

Other names 1

  • Dr. Elizabeth Ann Tenaglia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140624001092 TN Practitioner - Family Practice 6406806637 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Jun 1, 2014 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jun 1, 2014 Accepting new patients
Hospital Service District No. 2 Past Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

100 Vermont Ave
Oak Ridge, TN 37830
Phone (865) 482-1777

Organizations & group practices 4

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1396794392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEL",
        "first_name": "ELIZABETH",
        "middle_name": "TENAGLIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "48300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005627",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TENAGLIA",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.