Sherif Elmasry

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01045850A Issued in IN

Practice address

655 N Broadway
Peru, IN 46970

Phone

(765) 475-0024

Fax

(765) 475-0736

NPI assigned

Oct 6, 2006

Last updated

Jan 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Indiana Pediatric Associates LLC

  • Pediatrics Physician
  • Peru, IN
  • NPI 1902975642
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1972690634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "46970",
            "telephone_number": "765-475-0024",
            "fax_number": "765-475-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "46970",
            "telephone_number": "765-475-0024",
            "fax_number": "765-475-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMASRY",
        "first_name": "SHERIF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01045850A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200144460B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Joy Echelbarger, BA
• Lavonne Eddy, NP
• William Joseph Edwards II, PTA
• Sara E Eiler, BGS
• James Christopher Elkins III, BA
• Engaging Families, LLC
• Tara Engel, NP
• Nathan Epp, DO
• Katina A Everding, NP
• Eye Physicians Inc

• Pediatrics Physician in Peru, IN
• Providers in Peru, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.