Individual provider Active NPI

Waris Ali Waris

  • Medical Oncology Physician
  • Logan, WV
National Provider Identifier
1891807822
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
23735 Issued in WV
Practice address
20 Hospital Dr
Logan, WV 25601-3452
Phone
(304) 239-8070
Fax
(304) 239-8074
NPI assigned
Aug 31, 2006
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002655 NY
Medical Oncology Physician 207RX0202X 23735 WV Primary

Addresses

Primary practice location

20 Hospital Dr
Logan, WV 25601-3452

Mailing address

601 Holden Road
Logan, WV 25601
Phone (304) 239-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090817000344 WV Practitioner - Medical Oncology 7416955034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan General Hospital LLCGroup PAC ID 9537078977, 27 clinicians

Practice addresses (Care Compare)

1690 Holden Rd
Logan, WV 25601-7026
Phone (304) 239-2147

20 Hospital Dr
Logan, WV 25601-3452
Phone (304) 831-1801

38 Hospital Dr
Logan, WV 25601-3452
Phone (304) 831-1892

60 Hospital Dr
Logan, WV 25601-3452
Phone (304) 831-1804

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachia Pathology Consultants LLC Current Accepting new patients
Logan General Hospital LLC Internal Medicine CurrentSince Aug 1, 2009 Accepting new patients

Locations

1690 Holden Rd
Logan, WV 25601
Phone (304) 239-2147

1690 Holden Rd
Fl 1
Logan, WV 25601

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

Interoperability endpoints

  • Direct secure messaging: waris.waris.1@26088.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1891807822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HOLDEN ROAD",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-239-8070",
            "fax_number": "304-239-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-239-8070",
            "fax_number": "304-239-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARIS",
        "first_name": "WARIS",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "002655",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WV",
            "license": "23735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

Verify at the official NPI Registry.