Amena Khazaran

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71009412A Issued in IN

Practice address

875 Joliet St
Dyer, IN 46311-1920

Phone

(219) 440-7340

NPI assigned

Sep 26, 2019

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Express Care, IncGroup PAC ID 5193957595, 31 clinicians

Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians

Nwi Urgent Care, LLCGroup PAC ID 7618142977, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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 and National Provider Directory roles.

• Nwi Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Munster, IN
  • NPI 1043596703
  Medicare reassignment Care Compare group NPD
• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Hammond, IN
  • NPI 1629502810
  Medicare reassignment Care Compare group
• Midwest Express Care, Inc

  • Urgent Care Clinic/Center
  • Schererville, IN
  • NPI 1942642848
  Medicare reassignment Care Compare group
• Chantel Medical LLC

  • Internal Medicine Physician
  • Munster, IN
  • NPI 1427467273
  Medicare reassignment
• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  NPD (past)

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1689225138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111920",
            "telephone_number": "219-440-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111920",
            "telephone_number": "219-440-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZARAN",
        "first_name": "AMENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009412A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamad Kassar, M.D.
• Samer Kassar, MD
• Barry J Kaufman, D.O.
• Carla Kersten
• Anali Khalil
• Marco N. Khiella, MD
• Kidanu Birhanu MD SC
• Nathan Henry Kies, OTD
• Stacey Lynn Killeen, M.A, CCC-SLP
• Stephen K Kimani, LCSW

• Family Nurse Practitioner in Dyer, IN
• Providers in Dyer, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.