Hani Ahmad, MD
Individual provider Active NPI Psychiatry Physician · Fort Wayne, IN
NPI 1790711604 · NPPES record last updated May 11, 2023
Key facts
- NPI
- 1790711604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 01060341A (IN)
- Practice address
- 1720 Beacon St
Fort Wayne, IN 46805-4749 - Phone
- (260) 373-8000
- Fax
- (260) 373-8034
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bowen Health Inc
Beacon Medical Group Inc
Practice addresses (Care Compare)
2100 Goshen Rd
Fort Wayne, IN 46808-1493
Phone (574) 385-3474
707 N Michigan St
400 BMG Behavioral Health South Bend
South Bend, IN 46601-1071
Phone (574) 647-8470
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 |
|---|---|---|---|---|
| I20070426000561 | IN | Practitioner - Psychiatry | 4385740059 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME111572 | FL | MD | Psychiatry Physician |
| 01060341A | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Current | Accepting new patients | |
| Bowen Health Inc | Current |
Accepting new patients | |
| Bowen Health Inc | Current |
Accepting new patients | |
| Beacon Medical Group, Inc. | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current |
Accepting new patients | |
| Beacon Medical Group, Inc. | Psychiatry | Current |
Accepting new patients |
| Teladoc Health Medical Group, P.a. | Psychiatry | Current | Accepting new patients |
| Parkview Health System, Inc. | Current |
Accepting new patients | |
| Major Hospital | Past | Accepting new patients |
Locations
101 E Park Dr
Albion, IN 46701
Phone (260) 636-6884
200 Hoosier Dr
Ste E
Angola, IN 46703
Phone (260) 624-3741
923 Cardinal Ct
Auburn, IN 46706
Phone (260) 925-8035
1259 E State Road 205
Columbia City, IN 46725
Phone (260) 248-8176
119 W Market St
Columbia City, IN 46725
Phone (260) 248-8176
2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500
1818 Carew St
Ste 160
Fort Wayne, IN 46805
Phone (219) 436-0058
1720 Beacon St
Fort Wayne, IN 46805
Phone (260) 373-7500
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
2860 Northpark Ave
Huntington, IN 46750
Phone (260) 356-2875
1340 Etna Ave
Huntington, IN 46750
Phone (219) 356-2875
512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556
836 N Detroit St
Lagrange, IN 46761
Phone (260) 499-3019
707 N Michigan St
Ste 400
South Bend, IN 46601
Phone (574) 647-4500
901 S Huntington St
Syracuse, IN 46567
Phone (574) 385-3144
255 N Miami St
Wabash, IN 46992
Phone (260) 563-8446
901 Anchorage Rd
Warsaw, IN 46580
2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573
850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169
Interoperability endpoints
- haniahmad@tdh.allscriptsdirect.net
- hahmad5361@direct.parkviewexchange.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME111572 | FL | |
| Psychiatry Physician | 2084P0800X | 01060341A | IN | Yes |
Addresses
Primary practice location
1720 Beacon St
Fort Wayne, IN 46805-4749
Mailing address
15024 Remington PL
Fort Wayne, IN 46814-7599
Phone (317) 437-8061
Other practice location 1
707 N Michigan St Ste 400
South Bend, IN 46601-1071
Phone (574) 647-8470
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200825450 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hahmad5361@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/ |
Other providers in Fort Wayne, IN
- Christianah Agunanne
- Umunna Agunanne
- Doreen Y Agyeman
- Vinit Anil Aher
- Abid Ali Ahmad
- Hasan Bilal Ahmad
- Muhammod Ahmad
- Naveed Ahmad
- Abrar Justin Ahmed
- Giasuddin Ahmed
All providers in Fort Wayne, IN · 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 May 11, 2023. 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.