Individual provider Active NPI

Syed S Kazmi, MD

  • Family Medicine Physician
  • Merrillville, IN
National Provider Identifier
1154640902
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01077884A Issued in IN
Practice address
616 W 81St Ave
Merrillville, IN 46410-5307
Phone
(312) 421-1016
NPI assigned
Apr 20, 2007
Reactivated
May 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01077884A IN Primary

Addresses

Primary practice location

616 W 81St Ave
Merrillville, IN 46410-5307

Mailing address

1611 Fir Ave
Crown Point, IN 46307-9462
Phone (312) 217-2581

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180129000549 IN Practitioner - Family Practice 7416020565 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okolocha Medical CorpGroup PAC ID 5597794834, 4 clinicians

Practice addresses (Care Compare)

2054 Grant St
Gary, IN 46404-3060
Phone (219) 949-7540

Hospital & facility affiliations

  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
  • Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01077884AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Indiana Occupational Pain and Wellness Center, LLC CurrentSince Feb 1, 2023 Accepting new patients
Pinnacle Healthcare LLC Family Medicine CurrentSince Oct 15, 2019 Accepting new patients
Smart Physician Systems PC CurrentSince Mar 1, 2019 Accepting new patients
Pinnacle Healthcare, LLC Family Medicine CurrentSince Oct 15, 2019 Accepting new patients
Axess Clinic and Diagnostics LLC CurrentSince Dec 1, 2023 Accepting new patients
Okolocha Medical Corp. Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Southern Illinois Pain Management Past Accepting new patients
Rend Emergency Physicians Past Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

701 W Columbus Dr
East Chicago, IN 46312
Phone (219) 391-0014

6400 Melton Rd
Gary, IN 46403
Phone (219) 756-7246

8550 Broadway
Merrillville, IN 46410
Phone (219) 736-8888

10176 W 400 N
Ste A
Michigan City, IN 46360
Phone (219) 809-9839

8242 Calumet Ave
Ste 1
Munster, IN 46321
Phone (219) 595-0300

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1154640902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 FIR AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079462",
            "telephone_number": "312-217-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105307",
            "telephone_number": "312-421-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1154640902",
        "last_name": "KAZMI",
        "first_name": "SYED",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "deactivation_date": "2009-04-28",
        "reactivation_date": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01077884A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.