Individual provider Active NPI

Esam Alkhawaga

  • Psychiatry Physician
  • Xenia, OH
National Provider Identifier
1598847782
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35-088365 Issued in OH
Practice address
452 W Market St
Xenia, OH 45385-2815
Phone
(937) 376-8700
Fax
(937) 376-8725
NPI assigned
Oct 19, 2006
Last updated
Oct 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-088365 OH Primary

Addresses

Primary practice location

452 W Market St
Xenia, OH 45385-2815

Mailing address

452 W Market St
Xenia, OH 45385-2815
Phone (937) 376-8700

Other identifiers 1

IdentifierTypeStateIssuer
2706058MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070108000231 OH Practitioner - Psychiatry 3779571419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TCN Behavioral Health Services, Inc.Group PAC ID 8224011135, 20 clinicians

Practice addresses (Care Compare)

452 W Market St
Xenia, OH 45385-2815
Phone (937) 376-8700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-088365OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District 19 Community Services Board PastSince Oct 5, 2012 Accepting new patients
MCV Associated Physicians Psychiatry PastSince Sep 28, 2021 Accepting new patients
TCN Behavioral Health Services, Inc Psychiatry PastSince Nov 24, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/tcn/r4/

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1598847782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700",
            "fax_number": "937-376-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700",
            "fax_number": "937-376-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHAWAGA",
        "first_name": "ESAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-088365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2706058",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.