Honor Physicians, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

HONOR PHYSICIANS, LLC

Doing business as

Advanced Internal Medicine of Michiana, LLC

Practice address

3809 N Main St Ste 100
Mishawaka, IN 46545-3109

Phone

(574) 520-1700

Fax

(833) 989-0916

NPI assigned

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Amy Hurt, RMA

Title

Practice Manager

Phone

(574) 520-1700

Specialties & licenses 1

Addresses

Other names 1

• Advanced Internal Medicine of Michiana, LLC Doing business as

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

Locations

Practitioners 11

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.

• Dahan Hussein Al-Fadhl, M.D.

  • Internal Medicine Physician
  • Mishawaka, IN
  • NPI 1740235183
  Medicare reassignment Care Compare group NPD
• Adeela Masood Alizai, MD

  • Ophthalmology Physician
  • Mishawaka, IN
  • NPI 1306852520
  Medicare reassignment Care Compare group NPD
• Janet Ultreras

  • Family Nurse Practitioner
  • Mishawaka, IN
  • NPI 1093410375
  Medicare reassignment Care Compare group NPD
• Carole Anne Derucki, FNP-BC

  • Family Nurse Practitioner
  • Saint Joseph, MI
  • NPI 1205809225

  IN

  Medicare reassignment Care Compare group NPD
• Gamal Saleh, MD

  • Obstetrics & Gynecology Physician
  • Carmel, IN
  • NPI 1497907133
  Medicare reassignment NPD
• Jacob Thomas, MD

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1891957981
  Medicare reassignment NPD
• Khaleelur R Zackariya Sr., MD

  • Addiction Medicine (Internal Medicine) Physician
  • Mishiwaka, IN
  • NPI 1306854203
  Medicare reassignment NPD
• Ramesh Aggarwal, MD

  • Internal Medicine Physician
  • Bellwood, IL
  • NPI 1649458712

  IN

  Medicare reassignment NPD
• Jude Poku, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1205215415

  IN

  Medicare reassignment NPD
• Mackenzie S Warrick, PA

  • Physician Assistant
  • South Bend, IN
  • NPI 1730720301
  Medicare reassignment
• Bancy Mwangi, FNP-BC

  • Family Nurse Practitioner
  • South Bend, IN
  • NPI 1427828854
  NPD

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1194288860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 N MAIN ST STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453109",
            "telephone_number": "574-520-1700",
            "fax_number": "833-989-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 N MAIN ST STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453109",
            "telephone_number": "574-520-1700",
            "fax_number": "833-989-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONOR PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "HURT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "574-520-1700",
        "authorized_official_credential": "RMA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Internal Medicine of Michiana, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Cole Hollingsworth, D.P.M.
• Katherine Elise Holmes
• Sheila Clare Holody, LCSW, LMFT
• Home Town Pharmacy Inc (HomeTown Pharmacy #48 - Mishawaka)
• Hometown Pharmacy Inc. (Hometown Pharmacy #48 - Mishawaka)
• Hook-Superx LLC (CVS Pharmacy#08645)
• Hook-Superx LLC (CVS Pharmacy #06464)
• Hoosier Med Transport Services
• Hope- Filled Counseling LLC
• Alayiah Mariah-Lynn Hopson

• Primary Care Clinic/Center in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.