Individual provider Active NPI

Tameem Alsamsam, MD

  • Anesthesiology Physician
  • Fort Wayne, IN
National Provider Identifier
1740370915
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01052880A Issued in IN
Practice address
6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203
Phone
(260) 436-7875
Fax
(260) 432-9812
NPI assigned
Oct 16, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 015762 ME
Anesthesiology Physician 207L00000X 01052880A IN Primary

Addresses

Primary practice location

6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203

Mailing address

PO Box 843603
Dallas, TX 75284-0001
Phone (972) 233-1999

Other practice location 1

897 W Main St
Dover Foxcroft, ME 04426-1029
Phone (207) 564-4251

Other practice location 2

360 Broadway
Bangor, ME 04401-3979
Phone (207) 907-1430

Other identifiers 1

IdentifierTypeStateIssuer
300101314MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address talsamsam977175@direct-prd.goodhelpconnections.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, IN, KY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20061121000316 ME Practitioner - Anesthesiology 0042218331 Reassigns benefits to 3 organizations
I20250128000430 IN Practitioner - Anesthesiology 0042218331 Reassigns benefits to 2 organizations
I20250214000250 KY Practitioner - Anesthesiology 0042218331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians
Associated Anesthesiologists of Fort Wayne PCGroup PAC ID 2264412444, 101 clinicians
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8100

4023 Reas LN
New Albany, IN 47150-2228
Phone (812) 206-7660

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01052880AINMDAnesthesiology Physician
015762MEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Acadia Medical Arts Anesthesia LLC CurrentSince Jan 4, 2010 Accepting new patients
St. Joseph Hospital CurrentSince Sep 21, 2020 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Anesthesiology CurrentSince Mar 5, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince Oct 11, 2020 Accepting new patients
Eastern Maine Medical Center CurrentSince Oct 11, 2020 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
U S Anesthesia Partners of Kentucky PSC Anesthesiology PastSince Sep 1, 2023 Accepting new patients

Locations

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

4023 Reas Ln
New Albany, IN 47150
Phone (502) 690-6425

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4960 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-8000

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

489 State St
Bangor, ME 04401
Phone (207) 973-8837

73 Ridgewood Dr
Bangor, ME 04401
Phone (207) 433-7039

891 W Main St
Ste 200
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

Interoperability endpoints

  • Direct secure messaging: talsamsam1149017@direct.bsmhealth.org
  • Direct secure messaging: talsamsam977175@direct-prd.goodhelpconnections.org

Organizations & group practices 8

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 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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1740370915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD # 434",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "897 W Main St",
            "address_purpose": "LOCATION",
            "city": "Dover Foxcroft",
            "state": "ME",
            "postal_code": "044261029",
            "country_code": "US",
            "telephone_number": "207-564-4251",
            "fax_number": "207-564-4377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Broadway",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013979",
            "country_code": "US",
            "telephone_number": "207-907-1430",
            "fax_number": "207-907-3508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALSAMSAM",
        "first_name": "TAMEEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "015762",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01052880A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300101314",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "talsamsam977175@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.