NPIMap

Individual provider Active NPI

Luay Abuhassan

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1164022687
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26023963A Issued in IN
Practice address
3805 S Keystone Ave
Indianapolis, IN 46227-3540
Phone
(317) 786-3820
NPI assigned
Oct 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26023963A IN Primary

Addresses

Primary practice location

3805 S Keystone Ave
Indianapolis, IN 46227-3540

Mailing address

3805 S Keystone Ave
Indianapolis, IN 46227-3540
Phone (317) 786-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26023963AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP PastSince Nov 1, 2020 Accepting new patients
Wal-Mart Stores East LP PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1164022687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 S KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273540",
            "telephone_number": "317-786-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 S KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273540",
            "telephone_number": "317-786-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUHASSAN",
        "first_name": "LUAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26023963A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.