Individual provider Active NPI

Imad E Horani, M.D.

  • Gastroenterology Physician
  • Fort Wayne, IN
National Provider Identifier
1902895949
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01034917 Issued in IN
Practice address
2231 Carew St
Fort Wayne, IN 46805-4713
Phone
(260) 266-5230
Fax
(260) 373-9393
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 01034917 IN Primary

Addresses

Primary practice location

2231 Carew St
Fort Wayne, IN 46805-4713

Mailing address

1234 E Dupont Rd
Suite 3
Fort Wayne, IN 46825-1545
Phone (260) 373-7875

Other identifiers 8

IdentifierTypeStateIssuer
000000638370OtherINANTHEM
P00785645OtherINMEDICARE RR
4047092OtherINAETNA PROVIDER NUMBER
2765686001OtherINCIGNA PROVIDER NUMBER
0000000084166OtherINBCBS PROVIDER NUMBER
100006559OtherINRAILROAD MEDICARE
100331610MedicaidIN
3019003MedicaidOH

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
I20040823001416 IN Practitioner - Gastroenterology 1850283870 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01034917INMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System,Inc. Gastroenterology CurrentSince Nov 1, 2012 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

1234 E DuPont Rd
Ste 3
Fort Wayne, IN 46825
Phone (260) 373-9965

3926 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 266-8210

3439 Hobson Rd
#G
Fort Wayne, IN 46805
Phone (260) 484-2524

3439 Hobson Rd
Fort Wayne, IN 46805
Phone (219) 484-2524

2231 Carew St
Fort Wayne, IN 46805
Phone (260) 266-7856

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1902895949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD",
            "address_2": "SUITE 3",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-7875",
            "fax_number": "260-373-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054713",
            "telephone_number": "260-266-5230",
            "fax_number": "260-373-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORANI",
        "first_name": "IMAD",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01034917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000638370",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00785645",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4047092",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "2765686001",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0000000084166",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100006559",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100331610",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019003",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.