NPIMap

Organization Active NPI

Evansville Multi-Specialty Clinic, PC

  • Medical Oncology Physician
  • Evansville, IN
National Provider Identifier
1790730612
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
EVANSVILLE MULTI-SPECIALTY CLINIC, PC
Practice address
6140 E Columbia St
Evansville, IN 47715-9133
Phone
(812) 475-1948
Fax
(812) 401-5777
NPI assigned
May 23, 2006
Organization subpart
Yes
Parent organization
EVANSVILLE MULTI-SPECIALTY CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Dr. Lotfi Hadad, MEDICAL DOCTORNPI 1952362477
Title
Owner
Phone
(812) 475-1948

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6140 E Columbia St
Evansville, IN 47715-9133

Mailing address

PO Box 5646
Evansville, IN 47716-5646
Phone (812) 475-1948

Other identifiers 2

IdentifierTypeStateIssuer
200806260AMedicaidIN
000000391682OtherINBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126000624 IN Part B Supplier - Clinic/Group Practice 3779597976 Receives reassigned benefits from 11 practitioners
Practice locations: Evansville, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1053278Evansville Multi-Specialty Clinic PC6140 E Columbia St, Evansville, IN 47715Certificate of waiverJun 28, 2027

National Provider Directory

National Provider Directory
Part of
Evansville Multi Specialty Clinic PC

Locations

6140 E Columbia St
Evansville, IN 47715
Phone (812) 474-1110

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1790730612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5646",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165646",
            "telephone_number": "812-475-1948",
            "fax_number": "812-401-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 E COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159133",
            "telephone_number": "812-475-1948",
            "fax_number": "812-401-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSVILLE MULTI-SPECIALTY CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANSVILLE MULTI-SPECIALTY CLINIC, PC",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "HADAD",
        "authorized_official_first_name": "LOTFI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-475-1948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200806260A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000391682",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.