Abdali S. Jan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01051996A Issued in IN

Practice address

610 N Sawyer Rd
Kendallville, IN 46755-2566

Phone

(260) 347-5592

Fax

(260) 347-5155

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Internal Medicine Associates, PCGroup PAC ID 7113830688, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Health at Home LLC Home health agency, Fort Wayne, IN, CCN 157423
• Elara Caring Home health agency, Fort Wayne, IN, CCN 157243
• Orthopaedic Hospital at Parkview North Hospital, Fort Wayne, IN, CCN 150167
• Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146
• Parkview Huntington Hospital Hospital, Huntington, IN, CCN 150091
• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Parkview Dekalb Hospital Hospital, Auburn, IN, CCN 150045
• Parkview Hospital Inpatient rehabilitation facility, Fort Wayne, IN, CCN 15T021

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Merit-based Incentive Payment System (MIPS)

Final score

91.92 of 100Reported as group

Quality

81.41

Promoting interoperability

100

Improvement activities

40

Cost

78.75

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajan4378@direct.parkviewexchange.com

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

• Northeast Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Lagrange, IN
  • NPI 1174518500

  IN, Internal Medicine, OH

  Medicare reassignment Care Compare group NPD
• Northeast Internal Medicine Associates, PC

  • Primary Care Nurse Practitioner
  • Lagrange, IN
  • NPI 1366859779
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• A. C. & Associates, Inc.

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1013956440
  Care Compare affiliation
• Community Hospital of Noble County, Inc.

  • General Acute Care Hospital
  • Kendallville, IN
  • NPI 1457366189

  Hospital

  Care Compare affiliation
• Dekalb Memorial Hospital, Inc

  • General Acute Care Hospital
  • Auburn, IN
  • NPI 1902897937

  Hospital

  Care Compare affiliation
• Huntington Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Huntington, IN
  • NPI 1003821729

  Hospital

  Care Compare affiliation
• Orthopaedic Hospital at Parkview North, LLC

  • Special Hospital
  • Fort Wayne, IN
  • NPI 1568664613

  Hospital

  Care Compare affiliation
• Parkview Health at Home, LLC

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1861252918
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603

  Hospital

  Care Compare affiliation
• Parkview Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Fort Wayne, IN
  • NPI 1710993761

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1124013578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467610236",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N SAWYER RD",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552566",
            "telephone_number": "260-347-5592",
            "fax_number": "260-347-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N Detroit St",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "IN",
            "postal_code": "467611158",
            "country_code": "US",
            "telephone_number": "260-463-2133 x120",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 N Cass St",
            "address_purpose": "LOCATION",
            "city": "Wabash",
            "state": "IN",
            "postal_code": "469929416",
            "country_code": "US",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 E 7th St Ste G",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "467062518",
            "country_code": "US",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "885 W Connexion Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbia City",
            "state": "IN",
            "postal_code": "467251045",
            "country_code": "US",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2003 Stults Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "IN",
            "postal_code": "467501291",
            "country_code": "US",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Randallia Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054638",
            "country_code": "US",
            "telephone_number": "260-266-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAN",
        "first_name": "ABDALI",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01051996A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4301070135",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200301010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reshia Isaac
• Isd Kendallville LLC
• J M-Turner, Inc.
• Megan Jackson
• Yvette Jacobs
• Jansen & Jansen, D.C., Inc.
• Jansen Family Dentistry, P.C.
• Douglas A Jansen, DDS
• Gerard A. Jansen, D.C., L.AC.
• James S Jansen

• All providers in Kendallville, IN
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.