Anas Nader Ata Aljabari, MBBS

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Indianapolis, IN

NPI 1003489501 · NPPES record last updated Jun 29, 2025

Key facts

NPI
1003489501
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
113859 (NY)
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(856) 398-9630
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260423001509 NY Order and Referring Only - Neurosurgery
Practitioner - Neurosurgery
4385111756

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
113859NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 113859 NY Yes

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

9 Andrea Dr Apt C
Vestal, NY 13850-2256
Phone (856) 398-9630

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Student in an Organized Health Care Education/Training Program in Indiana

Sources for this page

Verify at the official NPI Registry.