NPIMap

Organization Active NPI

Shifa Clinic, P.C.

  • Specialist
  • Valparaiso, IN
National Provider Identifier
1639107790
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01044934A Issued in IN
Legal business name
SHIFA CLINIC, P.C.
Practice address
2701 Leonard Drive
Suite a
Valparaiso, IN 46383
Phone
(219) 464-9800
Fax
(219) 464-9877
NPI assigned
Jun 29, 2006
Last updated
Feb 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. Abdus Samad Lakhani, MDNPI 1831187244
Title
Owner Physician
Phone
(219) 464-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 01044934A IN Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 01062237A IN

Addresses

Primary practice location

2701 Leonard Drive
Suite a
Valparaiso, IN 46383

Mailing address

PO Box 552
Chesterton, IN 46304-0552
Phone (219) 464-9800

Other identifiers 1

IdentifierTypeStateIssuer
200178180AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070212000216 IN Part B Supplier - Clinic/Group Practice 1557363157 Receives reassigned benefits from 7 practitioners
Practice locations: Hobart, IN; Merrillville, IN; Portage, IN; Valparaiso, IN

National Provider Directory

National Provider Directory

Locations

2102 Evans Ave
Ste 110
Valparaiso, IN 46383
Phone (219) 464-9800

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1639107790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040552",
            "telephone_number": "219-464-9800",
            "fax_number": "219-464-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 LEONARD DRIVE",
            "address_2": "SUITE A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-464-9800",
            "fax_number": "219-464-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFA CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "LAKHANI",
        "authorized_official_first_name": "ABDUS",
        "authorized_official_middle_name": "SAMAD",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "219-464-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01044934A",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01062237A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200178180A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.