Fatima Khurrum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11012596 Issued in IN

Practice address

2434 Lake Ave
Fort Wayne, IN 46805-5406

Phone

(260) 423-2675

Fax

(260) 423-6621

NPI assigned

Aug 11, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other names 1

• Fatima Salim Former name

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

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Care Group PCGroup PAC ID 7416107487, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Select Medical Rehabilitation Hospital at Lutheran Inpatient rehabilitation facility, Fort Wayne, IN, CCN 153030

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.

• Hospital Care Group, P.C.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1295083624

  Family Medicine

  Medicare reassignment Care Compare group NPD
• FWBH, LLC

  dba Maple Heights Behavioral Health

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1932843117
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Rehab Hospital of Fort Wayne LLC

  dba Rehab Hospital of Fort Wayne

  • Rehabilitation Hospital
  • Fort Wayne, IN
  • NPI 1649221680

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609887942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHURRUM",
        "first_name": "FATIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11012596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FATIMA",
            "last_name": "SALIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashish Kumar Khemka, M.D
• Deepak Khemka, M.D.
• Manpreet Khemka, M.D.
• Mahmoud Khreis
• Shayan Khurram, DO
• Kids Speak Therapy Services
• Kids.Healthcare PC
• Shelby R Kiebel, NP
• Laura Kiefer, CD
• Felisha Kiehl, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.