| Dr Abdali S Jan, MD | |
|
610 N Sawyer Rd, Kendallville, IN 46755-2566 | |
| (260) 347-5592 | |
| (260) 347-5155 |
| Full Name | Dr Abdali S Jan |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 25 Years |
| Location | 610 N Sawyer Rd, Kendallville, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124013578 | NPI | - | NPPES |
| 4301070135 | Other | MI | MICHIGAN LICENSE |
| 200301010 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01051996A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Orthopaedic Hospital At Parkview North Llc | Fort wayne, IN | Hospital |
| Parkview Noble Hospital | Kendallville, IN | Hospital |
| Parkview Huntington Hospital | Huntington, IN | Hospital |
| Parkview Regional Medical Center | Fort wayne, IN | Hospital |
| Parkview Whitley Hospital | Columbia city, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeast Internal Medicine Associates, Pc | 7113830688 | 51 |
| Entity Name | Northeast Internal Medicine Associates, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174518500 PECOS PAC ID: 7113830688 Enrollment ID: O20031111000068 |
| Entity Name | Parkview Health System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932130952 PECOS PAC ID: 2163336967 Enrollment ID: O20031117000288 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Abdali S Jan, MD Po Box 236, Lagrange, IN 46761-0236 Ph: (260) 463-2133 | Dr Abdali S Jan, MD 610 N Sawyer Rd, Kendallville, IN 46755-2566 Ph: (260) 347-5592 |
Candy Lucero-palma, NP Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1844 Ida Red Rd, Kendallville, IN 46755 Phone: 260-347-8810 | |
Stanislawa Krystyna Koczorowska, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 727 E North St, Kendallville, IN 46755 Phone: 260-343-0797 Fax: 260-343-0799 | |
Sadaf Bangash, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 410 N Sawyer Rd, Kendallville, IN 46755 Phone: 260-347-0977 Fax: 260-347-8547 |