ESSAM Y. TELLAWI (NPI# 1093715690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093715690 |
Entity Type | Individual |
Full Name | ESSAM Y. TELLAWI |
Other Name | SAM Y TELLAWI |
Credential | M.D. |
Practice Address |
1601 Nw 114th St Ste 342 Clive IA 50325-7036 |
Mailing Address |
7700 Old Branch Ave Suite B-102 Clinton MD 20735-1628 |
Practice Telephone | 5152227600 |
Practice Fax Number | 5152227601 |
Mailing Telephone | 3018561960 |
Mailing Fax Number | 3018563206 |
Enumeration Date | 2005-07-26 |
Last Update Date | 2018-10-26 |
NPI Deactivation Date | 03/21/2006 |
NPI Reactivation Date | 2006-04-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD-45632 | IA | Allopathic & Osteopathic Physicians |
N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
01079882A | IN | Allopathic & Osteopathic Physicians |
N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
D34274 | MD | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DC | CAREFIRST | A618 0001 | 01 |
AMERIGROUP | 04834 | 01 | |
M.D. IPA | 218537 | 01 | |
AETNA | 4115912 | 01 | |
ALLIANCE | 318537 | 01 | |
MD | MEDICAL ASSISTANCE | 477271700 | 01 |
VA | BLUESHEILD | 219846 | 01 |
DC | MEDICAL ASSISTANCE | 026092800 | 01 |
GA | RAILROAD MEDICARE | 110032815 | 01 |
VA | MEDICAID | 1093715690 | 01 |
DC | MEDICARE | G02093S01 | 01 |
MD | MEDICARE | 248N273G | 01 |
MD | CAREFIRST | 54284801 | 01 |
EVERCARE | 2980177 | 01 | |
CIGNA | 107596 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 468451733 | 2602665230 | 2602665238 |
7700 Old Branch Ave, Suite B-102, Clinton, MD 207351628 | 3018561960 | 3018563206 |
Street Address |
1601 NW 114TH ST STE 342 |
City | CLIVE |
State | IA |
Zip Code | 50325-7036 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881020436 | Charleen Annette Ostrem | Nurse Practitioner | 1601 Nw 114th St Ste 342, Clive, IA 50325-7036 | 2013-09-15 |
1336377043 | Abdillahi Abdinoor | Internal Medicine | 1601 Nw 114th St Ste 342, Clive, IA 50325 | 2009-07-01 |
1588829188 | Vinaya Vittal Gaduputi | Internal Medicine | 1601 Nw 114th St Ste 342, Clive, IA 50325-7036 | 2008-07-23 |
1629248083 | Zinka Sarchet | Physician Assistant | 1601 Nw 114th St Ste 342, Clive, IA 50325 | 2008-03-01 |
1740242106 | Showkat Bashir | Internal Medicine | 1601 Nw 114th St Ste 342, Clive, IA 50325-7036 | 2006-04-03 |
1376531335 | Peter Grubel | Internal Medicine | 1601 Nw 114th St Ste 342, Clive, IA 50325-7036 | 2005-10-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104449446 | Clive Behavioral Health LLC | Psychiatric Hospital | 1500 Nw 114th St, Clive, IA 50325 | 2020-05-21 |
1609426519 | Caroline Silva Pereira Lara Ribeiro | Occupational Therapist | 15500 Boston Parkway, Appt 110, Clive, IA 50325 | 2019-09-13 |
1487203873 | Karen Turnure | Technician | 4524 Nw 16th St, Clive, IA 50325 | 2019-09-09 |
1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
1700288834 | Lindsey White | Chiropractor | 12931 University Ave, Suite 103, Clive, IA 50325 | 2014-09-19 |
1811337389 | Metro West Learning Center, LLC | Counselor | 13300 Hickman Rd Ste 110, Clive, IA 50325 | 2013-06-28 |
1700110343 | Rodolfo Mallorca Legislador Sr. | Family Medicine | 1665 Nw 97th St., Clive, IA 50325 | 2009-09-30 |
1891961900 | Erin Ducharme | Dermatology | 16349 Sheridan Drive, Suite 101, Clive, IA 50325 | 2008-05-08 |
1174792873 | The Iowa Clinic PC | Prosthetic/Orthotic Supplier | 12655 University Ave, Ste 160, Clive, IA 50325 | 2008-02-27 |
1164623393 | Melisa Coaker | Internal Medicine | 1275 Nw 128th St, Ste 200, Clive, IA 50325 | 2007-05-28 |
Find all providers in zip 50325 |
Taxonomy Code | 207RG0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Gastroenterology |
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275571747 | Iowa Digestive Disease Center P.C. | Internal Medicine | 1378 Nw 124th Street, Suite 200, Clive, IA 50325 | 2006-06-04 |
1497757009 | Allen R Kaufman | Internal Medicine | 1370 Nw 114th St, Suite 203, Clive, IA 50325-7030 | 2005-08-12 |
1528388998 | Mercy Clinics, Inc | Internal Medicine | 1601 Nw 114th St, Suite 342, Clive, IA 50325-7036 | 2010-06-08 |
1588829188 | Vinaya Vittal Gaduputi | Internal Medicine | 1601 Nw 114th St Ste 342, Clive, IA 50325-7036 | 2008-07-23 |
1336352772 | Tercio Lopes | Internal Medicine | 1378 Nw 124th St, Clive, IA 50325-8151 | 2007-05-08 |
1689629537 | Allen R. Kaufman, Md | Internal Medicine | 1370 Nw 114th St, Suite 203, Clive, IA 50325-7030 | 2006-05-22 |
1417908922 | Thomas Lyle Martin | Internal Medicine | 1378 Nw 124th St, Suite 200, Clive, IA 50325-8151 | 2006-05-12 |
1295793420 | Michael D Obrien | Internal Medicine | 1378 Nw 124th St, Suite 200, Clive, IA 50325-8151 | 2006-05-04 |
1912965146 | Stacey S Roberts | Internal Medicine | 1378 Nw 124th St, Suite 200, Clive, IA 50325-8151 | 2006-05-04 |
1992763122 | Ravi Prasad Sai Vemulapalli | Internal Medicine | 1378 Nw 124th St, Suite 200, Clive, IA 50325-8151 | 2006-05-04 |
Find all providers in CLIVE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.