Optimum Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01059379A Issued in IN

Legal business name

OPTIMUM PRIMARY CARE LLC

Practice address

7330 Indianapolis Blvd
Hammond, IN 46324-2941

Phone

(219) 844-1444

NPI assigned

May 18, 2009

Last updated

Mar 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Khaled A Reheem-Farag, MDNPI 1811931108

Title

President

Phone

(773) 841-9238

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Khaled A Reheem-Farag, M.D.

  • Internal Medicine Physician
  • Hammond, IN
  • NPI 1811931108
  Medicare reassignment NPD Authorized official
• Fatma Elzhra Hossini Ramadan, M.D.

  • Internal Medicine Physician
  • Chicago Heights, IL
  • NPI 1164548848
  NPD (past)

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301270400000",
    "number": "1073748216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 SARATOGA DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678740",
            "telephone_number": "773-841-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 INDIANAPOLIS BLVD",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463242941",
            "telephone_number": "219-844-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2011-03-28",
        "status": "A",
        "authorized_official_last_name": "REHEEM-FARAG",
        "authorized_official_first_name": "KHALED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-841-9238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059379A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL2028",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Ojomo, MD
• Terreah Oliver
• Marino Adrian Omelanczuk, PTA
• Oluwayomi Olalekan Omosebi, PT
• One to One Health (The Center for Healthy Living at PNW)
• Maryam Othman, DMD
• Pacific Healthcare, Inc.
• Krishna Pahuja, M.D.
• DO Ji Paik, MD
• Cortney Sloan Palencia, D.O.

• Internal Medicine Physician in Hammond, IN
• Providers in Hammond, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.