Individual provider Active NPI

Talieh Hendi, M.D.

  • Internal Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1861694341
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.091928 Issued in OH
Practice address
1425 N Fairfield Rd Ste 110
Beavercreek, OH 45432-2674
Phone
(937) 426-0106
Fax
(937) 426-7153
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 35.091928 OH Primary

Addresses

Primary practice location

1425 N Fairfield Rd Ste 110
Beavercreek, OH 45432-2674

Mailing address

1425 N Fairfield Rd. Ste 110
Beavercreek, OH 45432-2645
Phone (937) 426-0106

Other identifiers 1

IdentifierTypeStateIssuer
2915519MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.091928OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 2

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1861694341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N FAIRFIELD RD. STE 110",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322645",
            "telephone_number": "937-426-0106",
            "fax_number": "937-426-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N FAIRFIELD RD STE 110",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322674",
            "telephone_number": "937-426-0106",
            "fax_number": "937-426-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDI",
        "first_name": "TALIEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.091928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2915519",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.