Organization Active NPI

Karim Moshref MD PC

  • Primary Care Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1265863187
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
01042546 Issued in IN
Legal business name
KARIM MOSHREF MD PC
Practice address
2110 Lower Huntington Rd
Fort Wayne, IN 46819-1235
Phone
(260) 478-9960
Fax
(260) 478-9670
NPI assigned
Dec 2, 2013
Last updated
Dec 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Dr. Mir Abdul Karim Moshref, M.D.NPI 1073610689
Title
President/Ceo
Phone
(260) 478-9960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 01042546 IN Primary

Addresses

Primary practice location

2110 Lower Huntington Rd
Fort Wayne, IN 46819-1235

Mailing address

2110 Lower Huntington Rd
Fort Wayne, IN 46819-1235
Phone (260) 478-9960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210001728 IN Part B Supplier - Clinic/Group Practice 4486881802 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Wayne, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0975862Karim Moshref MD PC2110 Lower Huntington Rd, Ft Wayne, IN 46819Provider-performed microscopyJul 18, 2028

National Provider Directory

National Provider Directory

Locations

2110 Lower Huntington Rd
Fort Wayne, IN 46819
Phone (219) 478-9960

6050 S 800 E
#92
Fort Wayne, IN 46814
Phone (260) 625-3545

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1265863187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LOWER HUNTINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468191235",
            "telephone_number": "260-478-9960",
            "fax_number": "260-478-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 LOWER HUNTINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468191235",
            "telephone_number": "260-478-9960",
            "fax_number": "260-478-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARIM MOSHREF MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "MOSHREF",
        "authorized_official_first_name": "MIR ABDUL KARIM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "260-478-9960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01042546",
            "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 Dec 2, 2013; 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.