Moazzam Habib MD PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

01040236A Issued in IN

Legal business name

MOAZZAM HABIB MD PC

Practice address

9240 N Meridian St
Suite 240
Indianapolis, IN 46260-1880

Phone

(317) 571-0030

Fax

(317) 571-0031

NPI assigned

Jun 19, 2008

Organization subpart

No

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

Authorized official

Name

Sameer Habib

Title

Office Manager

Phone

(317) 571-0030

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sukhvir Kaur Benipal

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1457194896
  Medicare reassignment Care Compare group NPD
• Ariane Nicole Coyle, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1164940177
  Medicare reassignment Care Compare group NPD
• Moazzam W Habib, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Indianapolis, IN
  • NPI 1639270721

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Wendong Jiang, PA-C

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1528012796
  Medicare reassignment
• Amber Nicole Riley, NP-C

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
  • NPI 1437436706
  NPD (past)

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1003077488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40686",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462400686",
            "telephone_number": "317-571-0030",
            "fax_number": "317-571-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 N MERIDIAN ST",
            "address_2": "SUITE 240",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601880",
            "telephone_number": "317-571-0030",
            "fax_number": "317-571-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOAZZAM HABIB MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "HABIB",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-571-0030"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "01040236A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100358590B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000200129",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mlles Loving Hands Homecare LLC
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• MN Steady Transportation
• Candice Diane Moad, NP
• Mohannad Moallem, M.D.
• Dillon Mobasser, MD
• Mobell Home Care Services
• Mobell Lab Service LLC
• Steven Moberly, MD/PHD
• Mobile Audiology Associates, PC

• Endocrinology, Diabetes & Metabolism Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Endocrinology, Diabetes & Metabolism Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.