Active NPI
Columbia Medical Center LTD
- Internal Medicine Physician
- Highland, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- COLUMBIA MEDICAL CENTER LTD
- Practice address
- 9696 Gordon Dr
Highland, IN 46322-2909 - Phone
- (219) 937-2511
- Fax
- (219) 937-2522
- NPI assigned
- May 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Waddah Ahdab, MD
- Title
- Owner
- Phone
- (219) 937-2511
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
9696 Gordon Dr
Highland, IN 46322-2909
Mailing address
9696 Gordon Dr
Highland, IN 46322-2909
Phone (219) 937-2511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200114330A | Medicaid | IN |
Other names 1
- Medical Associates of Highland
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040723000653 | IN | Part B Supplier - Clinic/Group Practice | 7618957226 |
Receives reassigned benefits from 6 practitioners Practice locations: Highland, IN; Munster, IN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0959640 | Columbia Medical Center Dba Med Assoc of Highland | Certificate of waiver | Apr 14, 2027 |
National Provider Directory
National Provider DirectoryLocations
4320 Fir St
Unit 315
East Chicago, IN 46312
Phone (219) 392-2850
7400 Columbia Ave
Hammond, IN 46324
Phone (219) 803-4483
6414 Calumet Ave
Hammond, IN 46324
Phone (219) 595-9566
740 Seberger Dr
Munster, IN 46321
Phone (219) 237-6474
512 Ridge Rd
Munster, IN 46321
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Highland, IN
- NPI 1992979215
IN, Internal Medicine
-
- Infectious Disease Physician
- Highland, IN
- NPI 1255428157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1355356800000",
"number": "1275588386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9696 GORDON DR",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463222909",
"telephone_number": "219-937-2511",
"fax_number": "219-937-2522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9696 GORDON DR",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463222909",
"telephone_number": "219-937-2511",
"fax_number": "219-937-2522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLUMBIA MEDICAL CENTER LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-24",
"last_updated": "2012-12-13",
"status": "A",
"authorized_official_last_name": "AHDAB",
"authorized_official_first_name": "WADDAH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "219-937-2511",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200114330A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medical Associates of Highland",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Highland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.