| United Interventional Pain Center | |
|
7615 W Jefferson Blvd Fort Wayne IN 46804-4133 | |
| (260) 353-1444 | |
| (260) 353-1447 |
| Full Name | United Interventional Pain Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 7615 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Firas M Kara (OWNER) |
| Authorized Official Contact | 2604448999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Interventional Pain Center 10214 Chestnut Plaza Dr Pmb 228 Fort Wayne IN 46814-8970 Ph: (260) 444-8999 | United Interventional Pain Center 7615 W Jefferson Blvd Fort Wayne IN 46804-4133 Ph: (260) 353-1444 |
| NPI Number | 1356748685 |
|---|---|
| Provider Enumeration Date | 12/02/2014 |
| Last Update Date | 06/02/2025 |
| Certification Date | 06/02/2025 |
| Medicare PECOS PAC ID | 0941523823 |
|---|---|
| Medicare Enrollment ID | O20141229002188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356748685 | NPI | - | NPPES |
| 201267600 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | () | Secondary |
| Provider Name | Firas M Kara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700110822 PECOS PAC ID: 4789836529 Enrollment ID: I20121130000505 |
| Provider Name | Jennifer R Hillyard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104348531 PECOS PAC ID: 8224394572 Enrollment ID: I20171102001498 |
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