Active NPI
Ismail Tabash, MD
- Interventional Cardiology Physician
- Riverview, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 036166773
- Practice address
- 13127 Vail Ridge Dr
Riverview, FL 33579-7196 - Phone
- (813) 661-3199
- Fax
- (813) 661-6334
- NPI assigned
- Sep 6, 2011
- Last updated
- Sep 22, 2023
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R72859 | AZ | |
| Cardiovascular Disease Physician | 207RC0000X | 67458 | WI | |
| Cardiovascular Disease Physician | 207RC0000X | 036166773 | IL | |
| Interventional Cardiology Physician | 207RI0011X | ME156591 | FL | |
| Interventional Cardiology Physician | 207RI0011X | 036166773 | IL | Primary |
Addresses
Primary practice location
13127 Vail Ridge Dr
Riverview, FL 33579-7196
Mailing address
13127 Vail Ridge Dr
Riverview, FL 33579-7196
Phone (813) 661-3199
Other practice location 1
14525 Bruce B Downs Blvd # 5
Tampa, FL 33613-2789
Phone (813) 661-6199
Other practice location 2
4051 Upper Creek Dr Ste 110
Sun City Center, FL 33573-6825
Phone (813) 661-6199
Other practice location 3
425 S Kings Ave
Brandon, FL 33511-5919
Phone (813) 661-6199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114619700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1405 W Park St
Urbana, IL 61801-2367
Phone (217) 337-3240
2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311
812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- St Joseph Medical Center
- Saint James Hospital
- Osf Saint Elizabeth MDL Ctr
- Saint Francis Medical Center
- Osf Sacred Heart Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 33 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036166773 | IL | MD | Cardiovascular Disease Physician |
| 67458 | WI | MD | Cardiovascular Disease Physician |
| R72859 | AZ | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current | Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
210 Saint Joseph Dr
Bloomington, IL 61701
Phone (309) 663-5050
124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
2500 W Reynolds St
Ste 203205206207
Pontiac, IL 61764
Phone (815) 844-2001
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba Saint James Hospital - Multiple Hospital Departments
- Anesthesiology Physician
- Pontiac, IL
- NPI 1790735421
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba OSF Healthcare - Medical Group - Roanoke
- Rural Health Clinic/Center
- Roanoke, IL
- NPI 1164138848
-
dba OSF Healthcare - Medical Group (Non-RHC Billing)
- Family Medicine Physician
- Clinton, IL
- NPI 1356058119
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba OSF Sacred Heart Medical Center
- General Acute Care Hospital
- Danville, IL
- NPI 1699288449
-
dba OSF Saint Elizabeth Medical Center
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
dba Osf Saint James-John W Albrecht Medical Center
- General Acute Care Hospital
- Pontiac, IL
- NPI 1407808090
-
dba OSF Saint Joseph Medical Center
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1700167640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13127 VAIL RIDGE DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335797196",
"telephone_number": "813-661-3199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13127 VAIL RIDGE DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335797196",
"telephone_number": "813-661-3199",
"fax_number": "813-661-6334"
}
],
"practiceLocations": [
{
"address_1": "14525 Bruce B Downs Blvd # 5",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336132789",
"country_code": "US",
"telephone_number": "813-661-6199",
"fax_number": "813-661-6334",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4051 Upper Creek Dr Ste 110",
"address_purpose": "LOCATION",
"city": "Sun City Center",
"state": "FL",
"postal_code": "335736825",
"country_code": "US",
"telephone_number": "813-661-6199",
"fax_number": "813-661-6334",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "425 S Kings Ave",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335115919",
"country_code": "US",
"telephone_number": "813-661-6199",
"fax_number": "813-661-6334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TABASH",
"first_name": "ISMAIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-06",
"last_updated": "2023-09-22",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "R72859",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WI",
"license": "67458",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036166773",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "FL",
"license": "ME156591",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IL",
"license": "036166773",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114619700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Riverview, FL
- Synergic Healthcare Solutions LLC (Fast Track Urgent Care Center)
- Systems Change Therapy
- Levente J. Szalai, MD
- Gabriel Szmigiel, M.D.
- Ta Friendly Helpers
- Andrew David Tagle, APRN
- Take Control Physical Therapy Services, LLC
- Rebecca Talbert
- Tallahassee Orthopedic Clinic III PL
- Tallahassee Orthopedic Clinic III PL (Florida Orthopaedic Institute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.