| Hospital Care Group, P.c. | |
|
6435 W Jefferson Blvd Pmb 109 Fort Wayne IN 46804 | |
| (260) 344-4035 | |
| Not Available |
| Full Name | Hospital Care Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6435 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Khurrum Shaikh (PRESIDENT) |
| Authorized Official Contact | 2603127139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Care Group, P.c. 6435 W Jefferson Blvd Pmb 109 Fort Wayne IN 46804-6203 Ph: (260) 312-7139 | Hospital Care Group, P.c. 6435 W Jefferson Blvd Pmb 109 Fort Wayne IN 46804 Ph: (260) 344-4035 |
| NPI Number | 1295083624 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Medicare PECOS PAC ID | 7416107487 |
|---|---|
| Medicare Enrollment ID | O20121029000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295083624 | NPI | - | NPPES |
| 0071471 | Medicaid | OH |
| Provider Name | Layth Maolood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790788701 PECOS PAC ID: 5991699753 Enrollment ID: I20040211001252 |
| Provider Name | Mohammed A Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164545190 PECOS PAC ID: 7618961145 Enrollment ID: I20040408001106 |
| Provider Name | Khurrum A Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386683068 PECOS PAC ID: 1951371921 Enrollment ID: I20040727001662 |
| Provider Name | Scott W Jarvis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760466692 PECOS PAC ID: 5395782486 Enrollment ID: I20050411000798 |
| Provider Name | Douglas Cifuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689677544 PECOS PAC ID: 8224059969 Enrollment ID: I20051209000418 |
| Provider Name | Kombian Gbaruk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235171802 PECOS PAC ID: 3577569342 Enrollment ID: I20061018000584 |
| Provider Name | Bernice A Hawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811219108 PECOS PAC ID: 9638209372 Enrollment ID: I20100607000836 |
| Provider Name | Khaled M N Abuhanttash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184889180 PECOS PAC ID: 0143344382 Enrollment ID: I20140620000981 |
| Provider Name | Terri Renae Eldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982078465 PECOS PAC ID: 8325345606 Enrollment ID: I20160331001905 |
| Provider Name | Junyang Gong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801021183 PECOS PAC ID: 6406135763 Enrollment ID: I20161109002704 |
| Provider Name | Sheila A Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437608783 PECOS PAC ID: 5496035636 Enrollment ID: I20161206001086 |
| Provider Name | Karry L Clapper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841646833 PECOS PAC ID: 0345524070 Enrollment ID: I20170224001461 |
| Provider Name | Kamel Munther Massarweh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518373737 PECOS PAC ID: 8123305950 Enrollment ID: I20170621001010 |
| Provider Name | Kimberly Mcmurray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699129148 PECOS PAC ID: 8325337314 Enrollment ID: I20170905002643 |
| Provider Name | Angelita Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073025250 PECOS PAC ID: 1951661875 Enrollment ID: I20180213003212 |
| Provider Name | Jennifer Cohen |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1922528793 PECOS PAC ID: 8628331428 Enrollment ID: I20180409001505 |
| Provider Name | Derek C Forsthoefel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861754855 PECOS PAC ID: 7911139001 Enrollment ID: I20190624002530 |
| Provider Name | Ammar Asif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083135917 PECOS PAC ID: 4789008186 Enrollment ID: I20200717002202 |
| Provider Name | Sharon Worlton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003422858 PECOS PAC ID: 4587084678 Enrollment ID: I20201020002713 |
| Provider Name | Julie Lynn Hughett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861096398 PECOS PAC ID: 0446664536 Enrollment ID: I20210201002723 |
| Provider Name | Beenish Fayyaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649620675 PECOS PAC ID: 6507159332 Enrollment ID: I20210716002732 |
| Provider Name | Ruchi Bisen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578059044 PECOS PAC ID: 2668723867 Enrollment ID: I20210816002802 |
| Provider Name | George J. Moussally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013261973 PECOS PAC ID: 6507010600 Enrollment ID: I20220420001167 |
| Provider Name | Kathleen Rae Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477292431 PECOS PAC ID: 3274919725 Enrollment ID: I20221006000816 |
| Provider Name | Olajumoke Ayobami Ige |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497383566 PECOS PAC ID: 3375909617 Enrollment ID: I20230511002868 |
| Provider Name | Mark Alan Washington |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396079406 PECOS PAC ID: 9234372418 Enrollment ID: I20230919002549 |
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