Amirummul B Nusairee, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11017435A Issued in IN

Practice address

750 Broadway
Suite 150
Fort Wayne, IN 46802-1411

Phone

(260) 423-2682

Fax

(260) 422-4326

NPI assigned

Jun 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4
• Direct secure messaging: amirummul.nusairee.1@27998.direct.athenahealth.com

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.

• Circle Medical Care of California

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1134596091
  Medicare reassignment NPD
• Verity Medical Foundation

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1326312067
  Medicare reassignment NPD
• DCHS Medical Foundation

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1740597368

  Family Medicine

  NPD
• Fort Wayne Medical Education Program

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1184635153
  NPD (past)
• Action Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Jose, CA
  • NPI 1205186442
  NPD (past)
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1376983296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2675",
            "fax_number": "260-399-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSAIREE",
        "first_name": "AMIRUMMUL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11017435A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Nugent
• Andrea Numbers, DMD
• Tiffani Nunn
• Nurse Johnson Transportation LLC
• Nurtured Home Care LLC
• Abaigale Nussbaum, RN
• Nicholas Lee Nussbaum, M.D.
• Kloie Nutt, DO
• Nuvena Vein Center, LLC
• Chuck G Nwakanma

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.