Look up the most recent NPI and PECOS records

Jehangir Anwar Ansari

Internal Medicine

Allopathic & Osteopathic Physicians

11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701

(260) 266-2020 (260) 266-6013

PECOS Enrollment

This provider is enrolled in PECOS as JEHANGIR ANSARI.

Based on the most recent information from CMS, provider Jehangir Anwar Ansari is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1295034064
Provider Type
Individual
Full Name
Ansari, Jehangir Anwar
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/20/2011
Last Updated
12/6/2021

Contact Information

Practice Location

11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701

(260) 266-2020

Unlisted Fax

Mailing Location

3702 New Vision Dr Bldg B, Fort Wayne, IN 46845-1703

(260) 266-6013

(260) 458-5831

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 01078921A Indiana
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 2017030891 Missouri
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 2017030891 Missouri

Provider Identifiers

ID	Description	Issuer
ID 0104139	Description Medicaid	Issuer Unlisted Ohio

Jehangir Anwar Ansari

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Paudel, Kabita

Gurugubelli, Simhachalam

Neupane, Arpana

Anguh, Terence

Kinduell, Kevin Kyle

Niraula, Seejal

Vaziri, Mohammad Ali

Price, Steven L

Dhungana, Prabij

Santhanam Ethiraj, Sampath Kumar