Individual provider Active NPI

Sana Hussain Qureshi, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Wayne, IN
National Provider Identifier
1639444375
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
02006854A Issued in IN
Practice address
11141 Parkview Plaza Dr Ste 310
Fort Wayne, IN 46845-1714
Phone
(260) 266-8840
Fax
(260) 266-8849
NPI assigned
Mar 13, 2012
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036144710 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 02006854A IN Primary

Addresses

Primary practice location

11141 Parkview Plaza Dr Ste 310
Fort Wayne, IN 46845-1714

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other names 1

  • Sana Hussain Professional name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address squreshi505423@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180112002340 IL Practitioner - Endocrinology 2860751104 Reassigns benefits to 1 organization
I20220927001311 IN Practitioner - Endocrinology 2860751104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

11141 Parkview Plaza Dr
Suite 200
Fort Wayne, IN 46845-1714
Phone (260) 425-6030

512 N Professional Way
Kendallville, IN 46755-2927
Phone (260) 347-8556

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036144710ILMDEndocrinology, Diabetes & Metabolism Physician
02006854AINMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Jan 5, 2018 Accepting new patients
Riverside Health System Current Accepting new patients
Parkview Health System Inc Current Accepting new patients
Parkview Health System, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Sep 25, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

100 Fitness Dr
Bourbonnais, IL 60914
Phone (815) 936-6515

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: squreshi505423@direct.parkviewexchange.com

Organizations & group practices 6

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 5

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": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1639444375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 310",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451714",
            "telephone_number": "260-266-8840",
            "fax_number": "260-266-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "SANA",
        "middle_name": "HUSSAIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036144710",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "02006854A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "squreshi505423@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SANA",
            "last_name": "HUSSAIN",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.