NPIMap

Individual provider Active NPI

Zahid Saqib, MD

  • Family Medicine Physician
  • Carmi, IL
National Provider Identifier
1710063292
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036 05 8208 Issued in IL
Practice address
402 S Plum
Carmi, IL 62821
Phone
(618) 384-2226
Fax
(618) 382-5710
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036 05 8208 IL Primary

Addresses

Primary practice location

402 S Plum
Carmi, IL 62821

Mailing address

402 S Plum
Carmi, IL 62821
Phone (618) 384-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050622001144 IL Practitioner - Family PracticePractitioner - General Practice 4688619422 Practice locations: Carmi, IL; Enfield, IL; Grayville, IL
I20220321001859 IN Practitioner - Family Practice 4688619422 Reassigns benefits to 1 organization
Practice locations: Evansville, IN; New Harmony, IN
O20120530000649 IL Part A Provider - Rural Health Clinic 3779746771 Practice locations: Carmi, IL

Rural health clinic certification: CCN 143877

Legal name
ZAHID SAQIB, MD
Doing business as
DOCTORS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 7, 1994
Last certification
Nov 23, 2020
Ownership / control type
1A
Organization structure
Sole ProprietorProprietary
Enrollment address
402 Plum St
Carmi, IL 62821-1773

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Indiana LLCGroup PAC ID 6608111026, 25 clinicians

Practice addresses (Care Compare)

13219 N Meridian St
Carmel, IN 46032-5480
Phone (847) 821-6828

4488 Roslin Rd
Newburgh, IN 47630-8590
Phone (812) 710-4038

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • The Haven on the River Nursing home, Grayville, IL, CCN 146119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036 05 8208ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physician Group, Indiana LLC CurrentSince Feb 1, 2022 Accepting new patients
The Doctors Clinic Family Medicine Past Accepting new patients
Specialized Wound Management LLC Past Accepting new patients

Locations

13219 N Meridian St
Carmel, IN 46032
Phone (765) 751-5253

4488 Roslin Rd
Newburgh, IN 47630
Phone (812) 710-4038

Interoperability endpoints

  • Direct secure messaging: zsaqib42024@direct.deaconess.com

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Zahid Saqib Individual 5% Or Greater Direct Ownership Interest Apr 8, 2012 100%
Corporate Officer Apr 8, 2012
Corporate Director Apr 8, 2012
Bushra Saqib Individual Corporate Officer Apr 18, 2012
W-2 Managing Employee Apr 18, 2012

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1710063292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S PLUM",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "62821",
            "telephone_number": "618-384-2226",
            "fax_number": "618-382-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S PLUM",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "62821",
            "telephone_number": "618-384-2226",
            "fax_number": "618-382-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAQIB",
        "first_name": "ZAHID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036 05 8208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmi, IL

Sources for this page

Verify at the official NPI Registry.