Individual provider Active NPI

Tannous K Fakhry, MD

  • Surgery Physician
  • Erie, PA
National Provider Identifier
1962715821
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD466712 Issued in PA
Practice address
145 W 23Rd St Ste 303
Erie, PA 16502-2858
Phone
(814) 452-7800
Fax
(814) 452-7915
NPI assigned
Jul 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD466712 PA Primary

Addresses

Primary practice location

145 W 23Rd St Ste 303
Erie, PA 16502-2858

Mailing address

145 W 23Rd St Ste 303
Erie, PA 16502-2858
Phone (814) 452-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfakhry238459@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190909000524 PA Practitioner - General Surgery 3173815271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 W 23Rd St
303 SV Bariatrics and Metabolic
Erie, PA 16502-2858
Phone (814) 452-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD466712PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc Surgery CurrentSince Sep 1, 2019 Accepting new patients
Saint Vincent Health Center Past Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

145 W 23rd St
Ste 303
Erie, PA 16502
Phone (814) 452-7800

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 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": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1962715821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 303",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-7800",
            "fax_number": "814-452-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 303",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-7800",
            "fax_number": "814-452-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRY",
        "first_name": "TANNOUS",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD466712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfakhry238459@direct.ahn.org",
            "affiliation": "N",
            "address_1": "145 W 23rd St Ste 303",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165022858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.