NPIMap

Organization Active NPI

Pediatric Cardiology Associates

  • Specialist
  • Fort Wayne, IN
National Provider Identifier
1245600972
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01053679A Issued in IN
Legal business name
PEDIATRIC CARDIOLOGY ASSOCIATES
Practice address
5107 N Bend Dr
Fort Wayne, IN 46804-1753
Phone
(260) 459-6100
NPI assigned
Oct 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Dr. Mohammed Saad Ghazali, MD
Title
Physician
Phone
(260) 459-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 01053679A IN Primary

Addresses

Primary practice location

5107 N Bend Dr
Fort Wayne, IN 46804-1753

Mailing address

5107 N Bend Dr
Fort Wayne, IN 46804-1753
Phone (260) 459-6100

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1245600972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 N BEND DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041753",
            "telephone_number": "260-459-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 N BEND DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041753",
            "telephone_number": "260-459-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "GHAZALI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "SAAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "260-459-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01053679A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.