Khurrum A Shaikh, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01061057 Issued in IN

Practice address

2520 E Dupont Rd
Fort Wayne, IN 46825-1675

Phone

(260) 344-4035

Fax

(260) 969-9272

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH, IN2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Care Group PCGroup PAC ID 7416107487, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cameron Health Hospital, Angola, IN, CCN 151315
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshaikh626374@direct.osumc.edu

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 Care Group, P.C.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1295083624

  OH

  Medicare reassignment Care Compare group Authorized official
• FWBH, LLC

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1932843117
  Medicare reassignment NPD
• Hospital Care Group, P.C.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1578147724
  NPD Authorized official
• Community Memorial Hospital

  • Critical Access Hospital
  • Hicksville, OH
  • NPI 1730145392
  NPD (past)
• Medcentral Professional Foundation, LLC

  • Facial Plastic Surgery Physician
  • Mansfield, OH
  • NPI 1841476942

  Internal Medicine

  NPD (past)
• Northwest Ohio Emergency Services, Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1407992902
  NPD (past)
• Siraj Ahmed Siddiqui LLC

  • Internal Medicine Physician
  • Lexington, OH
  • NPI 1497934921
  NPD (past)

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

• Cameron Memorial Community Hospital, Inc.

  • Critical Access Hospital
  • Angola, IN
  • NPI 1386683316
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1386683068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD",
            "address_2": "PMB 109",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-344-4035",
            "fax_number": "260-969-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251675",
            "telephone_number": "260-344-4035",
            "fax_number": "260-969-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIKH",
        "first_name": "KHURRUM",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01061057",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35079807",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064359",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200826790",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "20549",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000547249",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "079774180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sailendra Kumar Shah
• Sargam Shah, RPT
• Swapnil Shah
• Fowad Shahzad, MD
• Usman Shahzad, MD
• Oluwatobi Shaleye
• Jeffrey Joseph Shambaugh, DMD
• Jennifer Shambaugh, NP
• Matthew E Shambaugh, MD
• Michael Eugene Shambaugh, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.