BLUE CRESCENT BLUE STAR MEDICAL OF INDIANA, INC (NPI# 1235438185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235438185 |
| Entity Type | Organization |
| Organization Name | BLUE CRESCENT BLUE STAR MEDICAL OF INDIANA, INC |
| Practice Address |
2326 Hobson Rd Fort Wayne IN 46805-2916 |
| Practice Telephone | 8598230000 |
| Mailing Telephone | 8598230000 |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |
| Authorized Official Name | DR. SUNDIATA M EL-AMIN (OWNER) |
| Authorized Official Telephone | 8598230000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2326 HOBSON RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053709402 | Sheila Falloon Md LLC | Internal Medicine | 6232 Shady Creek Ct, Fort Wayne, IN 46814-3298 | 2015-01-07 |
| 1043644354 | Fort Wayne Medical Clinic PC | Internal Medicine | 3537 N Anthony Blvd Ste C, Fort Wayne, IN 46805-1423 | 2013-08-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1215377296 | Ram Kishun Verma | Internal Medicine | 1234 E Dupont Rd Ste 5, Fort Wayne, IN 46825 | 2013-07-05 |
| 1871840934 | Amabel Pia A Lapuebla | Internal Medicine | 11104 Parkview Circle Dr Ste 440, Fort Wayne, IN 46845-1672 | 2012-08-08 |
| 1538432141 | C & D Healthcare Services, LLC | Internal Medicine | 327 E Wayne St, Fort Wayne, IN 46802-2753 | 2012-02-13 |
| 1407141500 | Patrick Joseph Wise | Internal Medicine | 6435 W Jefferson Blvd, Fort Wayne, IN 46804-6203 | 2011-06-16 |
| 1336441948 | Vishaal Veerula | Internal Medicine | 7802 W. Jefferson Blvd. #b, Fort Wayne, IN 46804 | 2010-12-02 |
| 1609019900 | Srisai P C | Internal Medicine | 7972 West Jefferson Blvd, Suite A, Fort Wayne, IN 46804-4140 | 2009-04-16 |
| 1508001157 | Mario Augusto Gomez | Internal Medicine | 2040 S Calhoun St, Fort Wayne, IN 46802-6412 | 2008-12-11 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on BLUE CRESCENT BLUE STAR MEDICAL OF INDIANA, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.