Nadine T Al Homsi, MD
Individual provider Active NPI Pediatrics Physician · Bloomington, IN
NPI 1205446325 · NPPES record last updated Aug 15, 2023
Key facts
- NPI
- 1205446325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01089158A (IN)
- Practice address
- 350 S Landmark Ave
Bloomington, IN 47403-5001 - Phone
- (812) 332-9874
- NPI assigned
- Aug 4, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230615003044 | IN | Practitioner - Pediatric Medicine | 6204251341 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01089158A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current |
Accepting new patients | |
| Indiana University Health Southern Indiana Physicians, LLC | Current |
Accepting new patients | |
| Indiana University Health Southern Indiana Physicians LLC | Current |
Accepting new patients |
Locations
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
Interoperability endpoints
- nalhomsi@direct.iuhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 01089158A | IN | Yes |
Addresses
Primary practice location
350 S Landmark Ave
Bloomington, IN 47403-5001
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090540875 | Other | IN | MEDICARE PTAN |
| 300041035 | Medicaid | IN |
Other providers in Bloomington, IN
- Vijay Kumar Agarwal
- Katie Agnew
- Abel R Aguilar
- Sebastian Roman Aguirre
- Meng Ai
- Nidal Al-Hosainat
- Basma Alaa Jafar Al-Saadi
- Farouq Bahaa Farouq Alahmed
- Alanicare LLC
- Brittany Albert
All providers in Bloomington, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.