Individual provider Active NPI

Tarek Odah, MD

  • Internal Medicine Physician
  • Framingham, MA
National Provider Identifier
1629599519
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
271787 Issued in MA
Practice address
115 Lincoln St
Framingham, MA 01702-6358
Phone
(508) 383-1000
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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 271787 MA Primary

Addresses

Primary practice location

115 Lincoln St
Framingham, MA 01702-6358

Mailing address

115 Lincoln St
Framingham, MA 01702-6358
Phone (508) 383-1572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001000575 MO Practitioner - Hospitalist 3173942778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Hospital & facility affiliations

  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271787MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center Internal Medicine CurrentSince Sep 29, 2020 Accepting new patients
Missouri Delta Medical Center CurrentSince Sep 29, 2020 Accepting new patients
Missouri Delta Medical Center Past Accepting new patients

Locations

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Interoperability endpoints

  • Direct secure messaging: todah675163@direct.saint-lukes.org

Organizations & group practices 3

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 2

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1629599519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "508-383-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "508-383-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAH",
        "first_name": "TAREK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "271787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.