Individual provider Active NPI

Noha Eltawil, M.D

  • Pediatrics Physician
  • Chandler, AZ
National Provider Identifier
1588929459
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
62102 Issued in AZ
Practice address
205 S Dobson Rd
Chandler, AZ 85224-6183
Phone
(602) 933-3480
Fax
(602) 933-4271
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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 62102 AZ Primary

Addresses

Primary practice location

205 S Dobson Rd
Chandler, AZ 85224-6183

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other identifiers 1

IdentifierTypeStateIssuer
088498MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210416002081 AZ Practitioner - Pediatric Medicine 2961712286 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 16, 2024 Accepting new patients
District Medical Group, Inc CurrentSince May 1, 2021 Accepting new patients
District Medical Group, Inc CurrentSince May 1, 2021 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Locations

205 S Dobson Rd
Ste 1
Chandler, AZ 85224
Phone (480) 963-6668

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

Interoperability endpoints

  • Direct secure messaging: neltawil848122@nychhc.direct-ci.com
  • Direct secure messaging: neltawil232111@direct.valleywisehealth.org

Organizations & group practices 5

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1588929459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S DOBSON RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246183",
            "telephone_number": "602-933-3480",
            "fax_number": "602-933-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTAWIL",
        "first_name": "NOHA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "62102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088498",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.