Individual provider Active NPI

Waqas Tariq, PA-C

  • Physician Assistant
  • Thomasville, NC
National Provider Identifier
1922453158
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06405 Issued in NC
Practice address
207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone
(336) 474-3444
Fax
(336) 474-8111
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-06405 NC
Physician Assistant 363A00000X 0010-06405 NC Primary

Addresses

Primary practice location

207 Old Lexington Rd
Thomasville, NC 27360-3428

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 474-3444

Other identifiers 1

IdentifierTypeStateIssuer
1922453158MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wtariq404755@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001005 NC Practitioner - Physician Assistant 7911298146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

203 Old Lexington Rd
Suite 101
Thomasville, NC 27360-3428
Phone (336) 474-4860

207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 476-2725

211 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 472-1191

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

  • Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care LLC CurrentSince May 23, 2016 Accepting new patients
Wake Forest Health Network, LLC CurrentSince May 23, 2016 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 10, 2016 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 10, 2016 Accepting new patients

Locations

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 6

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1922453158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-474-3444",
            "fax_number": "336-474-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 OLD LEXINGTON RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273603428",
            "telephone_number": "336-474-3444",
            "fax_number": "336-474-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "WAQAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06405",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922453158",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtariq404755@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "207 Old Lexington Rd",
            "city": "Thomasville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273603428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.