Individual provider Active NPI

Anan Bassam Afaneh, M.D.

  • Rheumatology Physician
  • Indianapolis, IN
National Provider Identifier
1407167273
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
01084594A Issued in IN
Practice address
6905 E 96TH St Ste 300
Indianapolis, IN 46250-4456
Phone
(317) 621-1510
Fax
(317) 621-1511
NPI assigned
Jun 28, 2010
Last updated
Nov 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2014030565 MO
Rheumatology Physician 207RR0500X 01084594A IN Primary

Addresses

Primary practice location

6905 E 96TH St Ste 300
Indianapolis, IN 46250-4456

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

100 Mercy Way
Ste 530
Joplin, MO 64804-4524
Phone (417) 556-5210

Other identifiers 1

IdentifierTypeStateIssuer
300043555MedicaidIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201104002221 IN Practitioner - Rheumatology 1456589688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

6905 E 96TH St
Suite 300
Indianapolis, IN 46250-4456
Phone (317) 621-9710

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Dec 14, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 14, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6905 E 96th St
Ste 300
Indianapolis, IN 46250
Phone (317) 359-3030

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7250 Clearvista Dr
Ste 330
Indianapolis, IN 46256
Phone (317) 621-1111

8202 Clearvista Pkwy
Ste 8B
Indianapolis, IN 46256
Phone (317) 436-8306

19800 East St
#120
Westfield, IN 46074
Phone (317) 621-7120

Interoperability endpoints

  • Direct secure messaging: aafaneh423869@ecommunitydirect.com
  • Direct secure messaging: aafaneh710935@directb.mercy.net

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1407167273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 E 96TH ST STE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462504456",
            "telephone_number": "317-621-1510",
            "fax_number": "317-621-1511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mercy Way",
            "address_2": "Ste 530",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648044524",
            "country_code": "US",
            "telephone_number": "417-556-5210",
            "fax_number": "417-556-5211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AFANEH",
        "first_name": "ANAN",
        "middle_name": "BASSAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "2014030565",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IN",
            "license": "01084594A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300043555",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.