Bahjat Sami Chabenne, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01024613A Issued in IN

Practice address

1400 N Ritter Ave
Suite 120
Indianapolis, IN 46219-3052

Phone

(317) 355-1000

Fax

(317) 355-5440

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Communitiy Hospitals of Indiana Inc

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1578646741
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1386718401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE",
            "address_2": "SUITE 120",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193052",
            "telephone_number": "317-355-1000",
            "fax_number": "317-355-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABENNE",
        "first_name": "BAHJAT",
        "middle_name": "SAMI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01024613A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000764829",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100058480A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01211599",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CG-Dsa, LLC
• CG-Dsa, LLC
• CG-Dsa, LLC
• CG-Dsa, LLC
• CH MH Services (in), LLC
• Lola Chabtini, M.D
• Andrew Chacko
• Ernestine Chaco, MD
• Marcela Chacon Dickerson, MD
• Chad R. Kauffman, DO, LLC

• Surgery Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.