NPIMap

Individual provider Active NPI

Kashif Manzoor, MD

  • Nephrology Physician
  • Indianapolis, IN
National Provider Identifier
1295785293
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01063014A Issued in IN
Practice address
5510 S East St Ste H
Indianapolis, IN 46227-1939
Phone
(317) 924-8425
Fax
(317) 924-8424
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01063014A IN Primary

Addresses

Primary practice location

5510 S East St Ste H
Indianapolis, IN 46227-1939

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other identifiers 1

IdentifierTypeStateIssuer
200880430MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071019000268 IN Practitioner - NephrologyPractitioner - Internal Medicine 7113945254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Northern Indiana PCGroup PAC ID 8921033440, 64 clinicians

Practice addresses (Care Compare)

7836 W Jefferson Blvd
101 Nephrology Associates of Northern India
Fort Wayne, IN 46804-4178
Phone (260) 494-3484

Hospital & facility affiliations

  • FMC - Indianapolis Dialysis facility, Indianapolis, IN, CCN 152500
  • FMC - Indianapolis-East Dialysis facility, Indianapolis, IN, CCN 152502
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128
  • Johnson Memorial Hospital Hospital, Franklin, IN, CCN 150001
  • Franciscan Health Mooresville Hospital, Mooresville, IN, CCN 150057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Indiana, Inc Nephrology CurrentSince Jun 1, 2019 Accepting new patients
Ghazala Quddus, M.D., Inc. Nephrology Past Accepting new patients
Kidney Care Consultants, PSC Nephrology Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

7836 W Jefferson Blvd
Ste 101
Fort Wayne, IN 46804

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

6820 Parkdale Pl
Ste 105
Indianapolis, IN 46254
Phone (317) 328-6730

5540 S East St
Ste 100
Indianapolis, IN 46227
Phone (317) 634-0920

2480 N Meridian St
Indianapolis, IN 46208
Phone (317) 923-4520

5510 S East St
Ste H
Indianapolis, IN 46227
Phone (317) 924-8420

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kmanzoor7537@direct.franciscanalliance.org
  • Direct secure messaging: kmanzoor23992@direct.acumenmd.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1295785293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000",
            "fax_number": "317-924-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S EAST ST STE H",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271939",
            "telephone_number": "317-924-8425",
            "fax_number": "317-924-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZOOR",
        "first_name": "KASHIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01063014A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200880430",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.