Individual provider Active NPI

Zeinab Hassan, NP

  • Gerontology Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1053024182
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71013456A Issued in IN
Practice address
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone
(260) 483-9081
Fax
(260) 483-9196
NPI assigned
Jan 4, 2023
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 71013456A IN Primary
Gerontology Registered Nurse 163WG0600X 28275072A IN

Addresses

Primary practice location

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Mailing address

PO Box 392552
Pittsburgh, PA 15251-9552
Phone (512) 792-4402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125001313 IN Practitioner - Nurse Practitioner 4981075215 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247

8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71013456AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Ecs, Inc CurrentSince Dec 19, 2024 Accepting new patients
Extended Care Specialists, Inc CurrentSince Jan 16, 2023 Accepting new patients
Eventus Ecs - Kentucky, PLLC CurrentSince Nov 1, 2025 Accepting new patients
Eventus WH Midwest Care, LLC CurrentSince Oct 1, 2025 Accepting new patients
Extended Care Specialists, Inc CurrentSince Oct 6, 2024 Accepting new patients

Locations

3512 Stellhorn Rd
Fort Wayne, IN 46815

150 W Market St
Ste 400
Indianapolis, IN 46204

3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 566-2035

8398 Mississippi St
Fl 2
Merrillville, IN 46410

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1053024182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392552",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519552",
            "telephone_number": "512-792-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "ZEINAB",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71013456A",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "IN",
            "license": "28275072A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.