Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eddy Elkassis

Individual provider Registered Nurse · NPI 1952053258

Eddy Elkassis is a Nurse Practitioner in Tempe, Arizona. Qualified in 2022, 4 years ago. Licensed in Arizona and Michigan.

Years since qualifying
4
Licensed in
AZ, MI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

995 E Baseline Rd Apt 2116
Tempe, AZ 85283-1363
Phone: (810) 813-5550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 305068 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence 4704369610 (MI)

Record details

NPI number1952053258
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 19, 2022
Last updated in NPPESNovember 2, 2024
Certification dateNovember 2, 2024
Mailing address6036 Jennifer Cres, West Bloomfield, MI 48324-3127

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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