Active NPI
Eugene F Tareshawty, M.D.
- Internal Medicine Physician
- Youngstown, OH
National Provider Identifier
1699779447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35-05-8757-T
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0775880 | Medicaid | OH |
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
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kauai Medical Clinic | Current | Accepting new patients | |
| Kauai Medical Clinic | Current | Accepting new patients | |
| Kapiolani Medical Center for Women & Children | Past | Accepting new patients | |
| Quest Diagnostics of Pennsylvania Inc | Past | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Lihue, HI
- NPI 1376596643
-
- Durable Medical Equipment & Medical Supplies
- Koloa, HI
- NPI 1871611558
-
- Clinical Medical Laboratory
- Boardman, OH
- NPI 1962659656
-
- Children's Hospital
- Honolulu, HI
- NPI 1043263080
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.