Individual provider Active NPI

Haris Adnan Siraj, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1982045902
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01076343A Issued in IN
Practice address
1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone
(317) 887-7805
NPI assigned
Jul 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301103703 MI
Internal Medicine Physician 207R00000X 01076343A IN Primary

Addresses

Primary practice location

1402 E County Line Rd
Indianapolis, IN 46227-0963

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Other practice location 1

601 W 2nd St
Bloomington, IN 47403-2317
Phone (812) 676-4542

Other practice location 2

1701 S Creasy Ln
Lafayette, IN 47905-4972
Phone (765) 502-4000

Other identifiers 1

IdentifierTypeStateIssuer
P01824796OtherINRR PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hsiraj198458@eCommunityDirect.com Community Physicians of Indiana Inc
Direct Messaging Address hsiraj532626@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SC, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160511000593 IN Practitioner - HospitalistPractitioner - Internal Medicine 4183913361 Reassigns benefits to 4 organizations
I20210322000920 SC Practitioner - Internal Medicine 4183913361 Reassigns benefits to 1 organization
I20241008004523 TX Practitioner - Internal Medicine 4183913361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Indiana LLCGroup PAC ID 6608111026, 25 clinicians
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13219 N Meridian St
Carmel, IN 46032-5480
Phone (847) 821-6828

1402 E County Line Rd
Indianapolis, IN 46227-0963
Phone (317) 887-7113

Hospital & facility affiliations

  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301103703MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Jan 24, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 24, 2017 Accepting new patients
In Charge Medical Professionals LLC Internal Medicine CurrentSince Aug 22, 2016 Accepting new patients
Impact Physician Group, Texas LLC Internal Medicine CurrentSince Jul 25, 2024 Accepting new patients
Impact Physician Group, South Carolina LLC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Margaret Mary Community Hospital, Inc Internal Medicine Current Accepting new patients
Impact Physician Group, Indiana LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients

Locations (25 of 28)

21 Eastbrook Bnd
Ste 218
Peachtree Cty, GA 30269
Phone (260) 407-8007

5819 Reliable Pkwy
Chicago, IL 60686

1912 S Park Ave
Alexandria, IN 46001
Phone (765) 724-4478

1821 Lindberg Rd
Anderson, IN 46012
Phone (317) 876-9955

321 Mitchell Ave
Batesville, IN 47006
Phone (812) 933-5018

501 S Murphy Ave
Brazil, IN 47834
Phone (812) 442-0403

1260 City Center Dr
Carmel, IN 46032
Phone (463) 333-9110

13219 N Meridian St
Carmel, IN 46032
Phone (765) 751-5253

281 S County Road 200 E
Connersville, IN 47331
Phone (765) 825-2148

801 N State St
Ste 2000
Greenfield, IN 46140
Phone (317) 325-2727

1 Memorial Sq
Ste 2200
Greenfield, IN 46140
Phone (317) 462-6662

1700 W 10th St
Indianapolis, IN 46222
Phone (317) 397-1718

8060 Knue Rd
Indianapolis, IN 46250
Phone (317) 782-6669

4141 Shore Dr
Indianapolis, IN 46254
Phone (317) 329-2000

7343 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 585-5400

3017 Valley Farms Rd
Indianapolis, IN 46214
Phone (317) 293-2555

4102 Shore Dr
Indianapolis, IN 46254
Phone (317) 347-9051

7240 Shadeland Sta
Ste 300
Indianapolis, IN 46256
Phone (317) 621-6060

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

4807 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 243-7727

4600 E Jackson St
Muncie, IN 47303
Phone (317) 243-3721

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

1121 E Lasalle Ave
South Bend, IN 46617
Phone (574) 287-6501

4600 W Washington St
South Bend, IN 46619
Phone (574) 282-1294

Interoperability endpoints

  • Direct secure messaging: haris.siraj@mmhealth.cernerdirect.com
  • Direct secure messaging: hsiraj198458@ecommunitydirect.com
  • Direct secure messaging: hsiraj532626@direct.franciscanalliance.org

Organizations & group practices 8

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 5

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1982045902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 E COUNTY LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462270963",
            "telephone_number": "317-887-7805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032317",
            "country_code": "US",
            "telephone_number": "812-676-4542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRAJ",
        "first_name": "HARIS",
        "middle_name": "ADNAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103703",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01076343A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "P01824796",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsiraj198458@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7240 Shadeland Station",
            "address_2": "Suite 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462563944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsiraj532626@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 S Creasy Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479054972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.