Individual provider Active NPI

Hani Ahmad, MD

  • Psychiatry Physician
  • Fort Wayne, IN
National Provider Identifier
1790711604
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01060341A Issued in IN
Practice address
1720 Beacon St
Fort Wayne, IN 46805-4749
Phone
(260) 373-8000
Fax
(260) 373-8034
NPI assigned
Jun 23, 2006
Last updated
May 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME111572 FL
Psychiatry Physician 2084P0800X 01060341A IN Primary

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

Electronic endpoints 3

TypeEndpointUseAffiliation
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/

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070426000561 IN Practitioner - Psychiatry 4385740059 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bowen Health IncGroup PAC ID 7618950965, 15 clinicians
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111572FLMDPsychiatry Physician
01060341AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Jul 1, 2006 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jul 17, 2021 Accepting new patients
Beacon Medical Group, Inc. Psychiatry CurrentSince Jul 17, 2021 Accepting new patients
Bowen Health Inc CurrentSince Jul 1, 2006 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Parkview Health System, Inc. CurrentSince Jul 22, 2018 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

119 W Market St
Columbia City, IN 46725
Phone (260) 248-8176

1259 E State Road 205
Columbia City, IN 46725
Phone (260) 248-8176

1720 Beacon St
Fort Wayne, IN 46805
Phone (260) 373-7500

1818 Carew St
Ste 160
Fort Wayne, IN 46805
Phone (219) 436-0058

2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500

1340 Etna Ave
Huntington, IN 46750
Phone (219) 356-2875

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

2860 Northpark Ave
Huntington, IN 46750
Phone (260) 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) 457-4400

255 N Miami St
Wabash, IN 46992
Phone (260) 563-8446

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

901 Anchorage Rd
Warsaw, IN 46580

Interoperability endpoints

  • Direct secure messaging: hahmad5361@direct.parkviewexchange.com
  • Direct secure messaging: haniahmad@tdh.allscriptsdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1790711604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15024 REMINGTON PL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468147599",
            "telephone_number": "317-437-8061",
            "fax_number": "727-877-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 BEACON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054749",
            "telephone_number": "260-373-8000",
            "fax_number": "260-373-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Michigan St Ste 400",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011071",
            "country_code": "US",
            "telephone_number": "574-647-8470",
            "fax_number": "574-647-8475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "HANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME111572",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01060341A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hahmad5361@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "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.