BASEM ALSARRAJ (NPI# 1124381942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124381942 |
| Entity Type | Individual |
| Full Name | BASEM ALSARRAJ |
| Credential | MD |
| Practice Address |
800 Broadway Ste 315 Fort Wayne IN 46802-2149 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604896030 |
| Practice Fax Number | 2604895536 |
| Mailing Telephone | 2604793516 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
01076411A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | OH | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201354450 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 700 Broadway, Fort Wayne, IN 468021402 | 4199360986 |
| Street Address |
800 BROADWAY STE 315 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46802-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609056779 | Allen County Ob-gyn Associates, PC | Obstetrics & Gynecology | 800 Broadway Ste 315, Fort Wayne, IN 46802-2149 | 2007-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
| 1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
| 1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
| 1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
| 1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
| 1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
| 1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
| Find all providers in zip 46802 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407166077 | Professional Psychiatric Services, LLC | Psychiatry & Neurology | 6203 Constitution Dr, Fort Wayne, IN 46804-1517 | 2010-10-18 |
| 1023233939 | David T Holmes Md PC | Psychiatry & Neurology | 7224 Engle Rd # 120, Fort Wayne, IN 46804-2222 | 2007-04-16 |
| 1447303326 | Joseph Paul Fiacable | Psychiatry & Neurology | 2426 Lake Ave, Fort Wayne, IN 46805-5406 | 2007-01-22 |
| 1013072180 | Raj Clinics Professional Services Corporation | Psychiatry & Neurology | 315 Airport North Office Park, Fort Wayne, IN 46825-6703 | 2006-12-27 |
| 1588676415 | S. Christopher Shim | Psychiatry & Neurology | 415 E Cook Rd Ste 500, Fort Wayne, IN 46825-3657 | 2006-08-12 |
| 1316980576 | Ronald Jerry Pancner | Psychiatry & Neurology | 2805 Fairfield Ave, Fort Wayne, IN 46807-1218 | 2006-06-14 |
| 1790762078 | Alycia Brown | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805-4764 | 2005-12-28 |
| 1417940909 | Mahender Reddy Surakanti | Psychiatry & Neurology | 7806 W Jefferson Blvd Ste C, Fort Wayne, IN 46804 | 2005-08-30 |
| 1245237411 | Prevesh K Rustagi | Psychiatry & Neurology | 3400 E Coliseum Blvd, Suite 340, Fort Wayne, IN 46805-1644 | 2005-07-03 |
| 1619377280 | Vinita Prasad | Psychiatry & Neurology | 1818 Carew St Ste 230, Fort Wayne, IN 46805 | 2014-09-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46802 |
Please comment or provide details below to improve the information on BASEM ALSARRAJ.
| 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.