Charnjit S Pabla, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01047177 Issued in IN

Practice address

2200 Randallia Dr
Fort Wayne, IN 46805-4638

Phone

(260) 373-4000

Fax

(260) 482-4442

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Greenway Trail Emergency Physicians LLC

  • Emergency Medicine Physician
  • Franklin, IN
  • NPI 1194093989
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Preferred Emergency Physicians

  • Emergency Medicine Physician
  • Portland, IN
  • NPI 1457302077
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1982682050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 NEW VISION DRIVE",
            "address_2": "SUITE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451717",
            "telephone_number": "260-482-4440",
            "fax_number": "260-482-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "260-373-4000",
            "fax_number": "260-482-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLA",
        "first_name": "CHARNJIT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01047177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200216290",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2617421",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000380603",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104874712",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPLAN",
            "identifier": "000000033413",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Elizabeth Oyler, PA-C
• Ece Ozen, MD
• P.E.T. Imaging Services, LLC
• PA Labs Inc
• PA Labs Inc
• Jorge Pablo, DPT
• Pace of Northeast Indiana
• Danielle Pacella, PA-C
• Amanda Jeanne Paden
• Rebecca Paden, RD

• Emergency Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.