Individual provider Active NPI

Tony Nimeh, MD

  • Urology Physician
  • Fairbanks, AK
National Provider Identifier
1760804777
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036135828 Issued in IL
Practice address
1211 Cushman St
Fairbanks, AK 99701-4680
Phone
(907) 328-0989
NPI assigned
Jan 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036135828 IL Primary

Addresses

Primary practice location

1211 Cushman St
Fairbanks, AK 99701-4680

Mailing address

104 Woodmont Blvd Ste 500
Nashville, TN 37205-2245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20180111001645 AK Practitioner - Urology 4183856032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as individual
Quality
84.53
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036135828ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Clinic Inc Current Accepting new patients
Fairbanks Urology Urology CurrentSince Apr 1, 2019 Accepting new patients
Alaska Neuroscience Associates,LLC Past Accepting new patients

Locations

1200 Airport Heights Dr
Ste 200
Anchorage, AK 99508
Phone (907) 250-6767

3851 Piper St
Ste U431
Anchorage, AK 99508
Phone (907) 215-6709

607 Old Steese Hwy
Ste B306
Fairbanks, AK 99701

1211 Cushman St
Fairbanks, AK 99701
Phone (907) 328-0989

1905 Cowles St
Ste B
Fairbanks, AK 99701
Phone (907) 371-1766

2485 Chief William Dr
Fairbanks, AK 99709
Phone (907) 238-0989

104 Woodmont Blvd
Ste 500
Nashville, TN 37205
Phone (615) 467-7400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFDCBD

Organizations & group practices 3

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": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1760804777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014680",
            "telephone_number": "907-328-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMEH",
        "first_name": "TONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-09",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036135828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.