Individual provider Active NPI

Abdelkarim Waness, MD

  • Internal Medicine Physician
  • Elyria, OH
National Provider Identifier
1639149131
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35066110 Issued in OH
Practice address
10325 Dewhurst Rd
Elyria, OH 44035-8403
Phone
(440) 366-3600
Fax
(440) 365-8826
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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 35066110 OH Primary

Addresses

Primary practice location

10325 Dewhurst Rd
Elyria, OH 44035-8403

Mailing address

1220 Moore Rd
Suite B
Avon, OH 44011-4044
Phone (440) 930-4446

Other identifiers 3

IdentifierTypeStateIssuer
000000128702OtherOHANTHEM
E66110OtherOHSUMMA
0979508MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35066110OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Ohio Heart Center Inc Internal Medicine Past Accepting new patients

Organizations & group practices 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1639149131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MOORE RD",
            "address_2": "SUITE B",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114044",
            "telephone_number": "440-930-4446",
            "fax_number": "440-934-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 DEWHURST RD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440358403",
            "telephone_number": "440-366-3600",
            "fax_number": "440-365-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANESS",
        "first_name": "ABDELKARIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35066110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000128702",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMA",
            "identifier": "E66110",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0979508",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.