Gohar A Salam, M.D., F.A.C.S.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01058885A Issued in IN

Practice address

11188 Diebold Rd
Fort Wayne, IN 46845-9662

Phone

(260) 483-9500

Fax

(260) 483-9511

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Retina Institute of Indiana, P.C.

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1457492167
  Medicare reassignment NPD Authorized official
• Retina Institute of Indiana Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1730442559

  Ophthalmology

  NPD Authorized official
• Indiana University Eye Care Inc.

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1548261894
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1285635334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11188 DIEBOLD RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459662",
            "telephone_number": "260-483-9500",
            "fax_number": "260-483-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11188 DIEBOLD RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459662",
            "telephone_number": "260-483-9500",
            "fax_number": "260-483-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAM",
        "first_name": "GOHAR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01058885A",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "130127411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7800696",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000364631",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "17842",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200484720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Sain-Stampley
• Chalaina Saine
• Constantine G Saites, MD, MS
• Tisa Salahud-Din
• Salam Home Care Agency LLC
• Adriana Salas
• Tiffany Jacqueline Salas, COTA
• Edna Beatriz Salazar, NP
• Numan Saleem
• Abdelaziz A Saleh, MD

• Ophthalmology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.