Active NPI
Wasim A Khasawneh, MD
- Neonatal-Perinatal Medicine Physician
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 01075923A
- Practice address
- 2600 Greenbush St
Lafayette, IN 47904-2477 - Phone
- (765) 448-8000
- Fax
- (765) 488-8564
- NPI assigned
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.098001 | OH | |
| Pediatrics Physician | 208000000X | 01075923A | IN | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 01075923A | IN | Primary |
| Pediatrics Physician | 208000000X | 57012659 | OH |
Addresses
Primary practice location
2600 Greenbush St
Lafayette, IN 47904-2477
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5510
Other practice location 2
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9852
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000964894 | Other | IN | ANTHEM PROVIDER NUMBER |
| 201320950 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wkhasawneh@direct.iuhealth.org | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.098001 | OH | MD | Pediatrics Physician |
| 57012659 | OH | MD | Pediatrics Physician |
| 01075923A | IN | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Methodist Hospitals, Inc | Current | Accepting new patients | |
| Arnett Clinic, LLC | Pediatrics | Current | Accepting new patients |
| Indiana University Health Southern Indiana Physicians, LLC | Current | Accepting new patients | |
| The Methodist Hospitals, Inc | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Iu Health Medical Group Riley Specialists, LLC | Pediatrics | Current | Accepting new patients |
Locations
8016 Reliable Pkwy
Chicago, IL 60686
27350 Network Pl
Chicago, IL 60673
2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
2600 Greenbush St
Lafayette, IN 47904
8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926
200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926
6121 Cleveland St
Merrillville, IN 46410
Phone (219) 738-5985
Interoperability endpoints
- wkhasawneh@direct.iuhealth.org
Organizations & group practices 8
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.
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- Durable Medical Equipment & Medical Supplies
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- Clinical Medical Laboratory
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- Durable Medical Equipment & Medical Supplies
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1508054446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 GREENBUSH ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042477",
"telephone_number": "765-448-8000",
"fax_number": "765-488-8564"
}
],
"practiceLocations": [
{
"address_1": "9500 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441950001",
"country_code": "US",
"telephone_number": "216-444-5510",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2651 E Discovery Pkwy",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "IN",
"postal_code": "474089059",
"country_code": "US",
"telephone_number": "812-353-9852",
"fax_number": "812-353-9278",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHASAWNEH",
"first_name": "WASIM",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-04",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35.098001",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01075923A",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IN",
"license": "01075923A",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "57012659",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000964894",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201320950",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wkhasawneh@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2651 E Discovery Pkwy",
"city": "Bloomington",
"state": "IN",
"country_code": "US",
"postal_code": "474089059",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.