Anjum S Ashraf, MD
Individual provider Active NPI Addiction Psychiatry Physician · Evansville, IN
NPI 1700833191 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1700833191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Psychiatry Physician 2084P0802X
- License
- 01048619A (IN)
- Practice address
- 3400 Lincoln Ave
Evansville, IN 47714-0147 - Phone
- (812) 469-6800
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- State of Indiana Auditor of State
Practice addresses (Care Compare)
3400 Lincoln Ave
Evansville, IN 47714-0146
Phone (812) 469-6800
Hospital & facility affiliations
- Ascension St Vincent Evansville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040823000410 | IN | Practitioner - Psychiatry |
3678568920 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01048619A | IN | MD | Addiction Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Indiana Auditor of State | Current |
Accepting new patients | |
| State of Indiana, Auditor of State | Current |
Accepting new patients | |
| State of Indiana, Auditor of State | Current | Accepting new patients |
Locations
3400 Lincoln Ave
Evansville, IN 47714
Phone (812) 469-6800
1098 S State Road 25
Logansport, IN 46947
Phone (574) 722-4141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 01048619A | IN | Yes |
Addresses
Primary practice location
3400 Lincoln Ave
Evansville, IN 47714-0147
Mailing address
3400 Lincoln Ave
Evansville, IN 47714-0147
Phone (812) 469-6800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000328027 | Other | IN | ANTHEM PROVIDER # |
| 100180890L | Medicaid | IN | |
| P00119093 | Other | IN | INDIV. RR MEDICARE # |
| 200478750 | Medicaid | IN |
NPI Registry JSON
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1700833191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140147",
"telephone_number": "812-469-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140147",
"telephone_number": "812-469-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHRAF",
"first_name": "ANJUM",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "IN",
"license": "01048619A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER #",
"identifier": "000000328027",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100180890L",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIV. RR MEDICARE #",
"identifier": "P00119093",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200478750",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
- Kirk D Ashburn II
- James H. Ashby II
- Chad Ashley
- Drew Shelton Ashley
- Karissa Ashlock
- Monika Ashwin
- Olivia Askins
- Lee-Ann Susan Assalone
- Maansi Asthana
- At Home Rehab and Nursing Inc,
All providers in Evansville, IN · Addiction Psychiatry Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.