NPIMap

Individual provider Active NPI

Syed A Ali, MD

  • Internal Medicine Physician
  • Boonville, IN
National Provider Identifier
1528055662
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01026430A Issued in IN
Practice address
1301 Millis Ave
Boonville, IN 47601-2329
Phone
(812) 897-4458
Fax
(812) 897-5977
NPI assigned
Oct 4, 2005
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01026430A IN Primary

Addresses

Primary practice location

1301 Millis Ave
Boonville, IN 47601-2329

Mailing address

PO Box 467
Boonville, IN 47601-0467
Phone (812) 897-4458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000421 IN Practitioner - Internal Medicine 0941276174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 Millis Ave
Boonville, IN 47601-2329
Phone (812) 897-4458

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01026430AINMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: syed.ali.1@1834.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Transcendent Healthcare of BoonvilleBoonville, IN, CCN 155508 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2009
Jul 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Major Hospital

    dba Transcendent Healthcare of Boonville

    • Skilled Nursing Facility
    • Boonville, IN
    • NPI 1457569915

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 1

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 10

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1528055662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476010467",
            "telephone_number": "812-897-4458",
            "fax_number": "812-897-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MILLIS AVE",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476012329",
            "telephone_number": "812-897-4458",
            "fax_number": "812-897-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "SYED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01026430A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

Verify at the official NPI Registry.