Individual provider Active NPI

Tariq Wael Zakaria, DO

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1841931938
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13708 Issued in GA
Practice address
1500 Oglethorpe Ave Ste 200D
Athens, GA 30606-2165
Phone
(706) 389-3875
Fax
(706) 389-3876
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 13708 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave Ste 200D
Athens, GA 30606-2165

Mailing address

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 389-3860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250917000526 SC Practitioner - Internal Medicine 0446631105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13708GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients

Locations

1000 Wellness Way
Fort Mill, SC 29715
Phone (803) 329-1234

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1841931938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "706-389-3860",
            "fax_number": "706-389-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 200D",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062165",
            "telephone_number": "706-389-3875",
            "fax_number": "706-389-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKARIA",
        "first_name": "TARIQ",
        "middle_name": "WAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "13708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.