Individual provider Active NPI

Khaled A Reheem-Farag, M.D.

  • Internal Medicine Physician
  • Hammond, IN
National Provider Identifier
1811931108
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01059379A Issued in IN
Practice address
7330 Indianapolis Blvd
Hammond, IN 46324-2941
Phone
(219) 844-1444
Fax
(219) 844-1448
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01059379A IN Primary

Addresses

Primary practice location

7330 Indianapolis Blvd
Hammond, IN 46324-2941

Mailing address

7330 Indianapolis Blvd
Hammond, IN 46324-2941
Phone (219) 844-1444

Other identifiers 1

IdentifierTypeStateIssuer
200495810MedicaidIN

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
I20041101000634 IN Practitioner - Interventional CardiologyPractitioner - Internal Medicine 0143282228 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

7330 Indianapolis Blvd
Hammond, IN 46324-2941
Phone (219) 844-1444

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059379AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians, PC Internal Medicine Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Feb 1, 2023 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Feb 1, 2023 Accepting new patients
Optimum Primary Care LLC Internal Medicine CurrentSince Apr 6, 2009 Accepting new patients
Community Care Network Inc Internal Medicine CurrentSince Apr 21, 2015 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

9121 159th St
Ste D
Orland Hills, IL 60487
Phone (708) 403-1155

7330 Indianapolis Blvd
Hammond, IN 46324
Phone (219) 844-1444

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 5

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 2

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1811931108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 INDIANAPOLIS BLVD",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463242941",
            "telephone_number": "219-844-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 INDIANAPOLIS BLVD",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463242941",
            "telephone_number": "219-844-1444",
            "fax_number": "219-844-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHEEM-FARAG",
        "first_name": "KHALED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059379A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.