Individual provider Active NPI

Walid M Hafez, MD

  • Neurology Physician
  • Germantown, TN
National Provider Identifier
1902814957
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
63398 Issued in TN
Practice address
7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751
Phone
(901) 405-0275
Fax
(901) 405-0287
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036056609 IL
Neurology Physician 2084N0400X 036.056609 IL
Neurology Physician 2084N0400X 63398 TN Primary

Addresses

Primary practice location

7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751

Mailing address

7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751

Other identifiers 1

IdentifierTypeStateIssuer
036056609MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240118002115 TN Practitioner - Neurology 9739267899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Memphis Neurology PLLCGroup PAC ID 2264510718, 6 clinicians

Practice addresses (Care Compare)

1785 Nonconnah Blvd
Memphis, TN 38132-2139
Phone (901) 344-0101

7645 Wolf River Cir
Suite 100
Germantown, TN 38138-1751
Phone (901) 405-0275

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.056609ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Neurology PLLC Neurology CurrentSince Jan 1, 2024 Accepting new patients

Locations

7645 Wolf River Cir
Memphis, TN 38138
Phone (901) 405-0275

7645 Wolf River Cir
Ste 100
Memphis, TN 38138
Phone (901) 405-0275

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73850

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 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1902814957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275",
            "fax_number": "901-405-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEZ",
        "first_name": "WALID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036056609",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.056609",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "63398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056609",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.