Bader Ibrahim Alkharisi

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

310234 Issued in LA

Practice address

1514 Jefferson Hwy
Jefferson, LA 70121-2429

Phone

(504) 842-3925

NPI assigned

Aug 6, 2018

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2018.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1659859296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 DICKORY AVE APT C221",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232278",
            "telephone_number": "312-522-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHARISI",
        "first_name": "BADER",
        "middle_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "310234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sairavish Akkineni
• Kali A Albright, NP
• Sarah Jane Aleman
• Heather Alexander, PA-C
• Ala Ihab Alkasrawi, M.D.
• Remi Alexander Allen, MD
• Alliance Medical Diagnostics LLC
• Ashlyn Marie Alongi, MD
• Alpha Pharmaceutical
• Jason Paul Amadeo, PA-C

• All providers in Jefferson, LA
• Student in an Organized Health Care Education/Training Program in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.