Individual provider Active NPI

Imtisaal Waris

  • Student in an Organized Health Care Education/Training Program
  • Lancaster, OH
National Provider Identifier
1922673433
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2405 N Columbus St Ste 260
Lancaster, OH 43130-8100
Phone
(740) 637-8397
Fax
(740) 654-4103
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2405 N Columbus St Ste 260
Lancaster, OH 43130-8100

Mailing address

2405 N Columbus St Ste 260
Lancaster, OH 43130-8100
Phone (740) 637-8397

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
I20260213000439 WV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4082015334

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1922673433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST STE 260",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308100",
            "telephone_number": "740-637-8397",
            "fax_number": "740-654-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST STE 260",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308100",
            "telephone_number": "740-637-8397",
            "fax_number": "740-654-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARIS",
        "first_name": "IMTISAAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.