Individual provider Active NPI

Eugene F Tareshawty, M.D.

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1699779447
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-05-8757-T Issued in OH
Practice address
835 Southwestern Run
Youngstown, OH 44514-3688
Phone
(330) 318-1100
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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 35-05-8757-T OH Primary

Addresses

Primary practice location

835 Southwestern Run
Youngstown, OH 44514-3688

Mailing address

PO Box 786536
Philadelphia, PA 19178-6536

Other identifiers 1

IdentifierTypeStateIssuer
0775880MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20191206001676 HI Practitioner - Internal Medicine 8527057579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince Oct 9, 2019 Accepting new patients
Kauai Medical Clinic CurrentSince Oct 9, 2019 Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients
Quest Diagnostics of Pennsylvania Inc PastSince May 15, 2002 Accepting new patients

Locations

4-831 Kuhio Hwy
Ste 332
Kapaa, HI 96746

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Interoperability endpoints

  • Direct secure messaging: eugene.tareshawty@hope.ikm.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1699779447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786536",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191786536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SOUTHWESTERN RUN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445143688",
            "telephone_number": "330-318-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARESHAWTY",
        "first_name": "EUGENE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-05-8757-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0775880",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.