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

Omar Tarek Ellaicy, MD

Individual provider Internal Medicine Physician · NPI 1346990058

Omar Tarek Ellaicy, MD is an Internal Medicine Physician in Louisville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2022.

Licensed in
KY
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

530 S Jackson St
Louisville, KY 40202-1675
Phone: (502) 562-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence R6772 (KY)

Record details

NPI number1346990058
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2022
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026

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