NPIMap

Individual provider Active NPI

Abdus Samad Lakhani, MD

  • Internal Medicine Physician
  • Valparaiso, IN
National Provider Identifier
1831187244
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01044934A Issued in IN
Practice address
2701 Leonard Drive
Suite a
Valparaiso, IN 46383
Phone
(219) 464-9800
Fax
(219) 464-9877
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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 01044934A IN Primary

Addresses

Primary practice location

2701 Leonard Drive
Suite a
Valparaiso, IN 46383

Mailing address

PO Box 552
Chesterton, IN 46304-0552
Phone (219) 464-9800

Other identifiers 1

IdentifierTypeStateIssuer
200178180AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070212000334 IN Practitioner - Internal MedicinePractitioner - General Practice 8628070224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shifa Clinic PCGroup PAC ID 1557363157, 3 clinicians

Practice addresses (Care Compare)

2701 Leonard Dr a
Valparaiso, IN 46383-7121
Phone (219) 464-9800

3630 Willowcreek Rd
Portage, IN 46368-5075

802 Laporte Ave
Valparaiso, IN 46383-5860
Phone (219) 477-5242

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue40
Removal of skin lesions36
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01044934AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shifa Clinic, P.C. CurrentSince Jul 1, 2006 Accepting new patients

Locations

3630 Willowcreek Rd
Fl 3
Portage, IN 46368
Phone (219) 364-3800

2701 Leonard Dr
#A
Valparaiso, IN 46383
Phone (219) 464-9800

Organizations & group practices 2

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 11

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1831187244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040552",
            "telephone_number": "219-464-9800",
            "fax_number": "219-464-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 LEONARD DRIVE",
            "address_2": "SUITE A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-464-9800",
            "fax_number": "219-464-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKHANI",
        "first_name": "ABDUS",
        "middle_name": "SAMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01044934A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200178180A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.