NPIMap

Individual provider Active NPI

Imran Hasanuddin, M.D.

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1942409370
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01084498A Issued in IN
Practice address
701 E County Line Rd Ste 101
Greenwood, IN 46143-1070
Phone
(317) 885-2860
Fax
(317) 885-2869
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 01084498A IN
Family Medicine Physician 207Q00000X 01084498A IN Primary

Addresses

Primary practice location

701 E County Line Rd Ste 101
Greenwood, IN 46143-1070

Mailing address

701 E County Line Rd Ste 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Other identifiers 1

IdentifierTypeStateIssuer
300044297MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.indianainternalmedicine@ccme.com Direct

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
I20201013001668 IN Practitioner - Family PracticePractitioner - Hospitalist 1153503271 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Medical Group LLCGroup PAC ID 7012067697, 113 clinicians
Indiana Internal Medicine Consultants LLCGroup PAC ID 7911899489, 43 clinicians

Practice addresses (Care Compare)

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01084498AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Medical Group LLC CurrentSince Oct 1, 2020 Accepting new patients
St. Francis Medical Group, LLC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Indiana Internal Medicine Consultants, LLC. Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
St. Francis Hospital and Health Centers Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

701 E County Line Rd
Greenwood, IN 46143
Phone (317) 885-2860

701 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 885-2860

701 E County Line Rd
Ste 301
Greenwood, IN 46143
Phone (317) 883-4736

Interoperability endpoints

  • Direct secure messaging: ihasanuddin533844@direct.franciscanalliance.org
  • Direct secure messaging: direct.indianainternalmedicine@ccme.com

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 7

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1942409370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD STE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD STE 101",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431070",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASANUDDIN",
        "first_name": "IMRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01084498A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01084498A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300044297",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.indianainternalmedicine@ccme.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E County Line Rd Ste 101",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.