Zeenat Habibullah, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

01098178A Issued in IN

Practice address

3005 E State Blvd
Fort Wayne, IN 46805-4736

Phone

(260) 267-9498

NPI assigned

Jun 4, 2022

Last updated

Oct 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Addiction MedicineAlso: Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment Care Compare group NPD
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1487393690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054736",
            "telephone_number": "260-267-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054736",
            "telephone_number": "260-267-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBULLAH",
        "first_name": "ZEENAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-04",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01098178A",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "KS",
            "license": "94-11590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathon Habeshy, PTA
• Anwer K Habib, M.D.
• Leah M Habib, MD
• Sajjad H Habib, MD
• Zayaan Habib, PHARMD
• Taquoia Hackbush
• Tia Hackbush, RBT, BS
• Jessica Lynn Hackenberg, PSY.D.
• Jillian Ann Hacker, ATC
• Emily Nicole Hackett

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.