Individual provider Active NPI

Ibrahim Khurram Nawaz, MD

  • Internal Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1457036022
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01098325A Issued in IN
Practice address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Phone
(260) 672-6620
Fax
(260) 672-6639
NPI assigned
Jun 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 01098325A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

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
I20230711003454 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6204295066

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01098325AINMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: inawaz568126@direct.parkviewexchange.com

Hospital & facility affiliations 1

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1457036022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-672-6620",
            "fax_number": "260-672-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWAZ",
        "first_name": "IBRAHIM KHURRAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01098325A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.