ABDUL SAMI QAZI M.D.
NPI 1366508228
Hospitalist in Plymouth, IN

NPI Status: Active since December 28, 2006

Contact Information

1915 LAKE AVE
PLYMOUTH, IN
ZIP 46563
Phone: (574) 948-4000
Fax: (574) 948-5454

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  • Individual
  • Male
  • Years of Experience 27
  • Hospitalist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ABDUL QAZI

This page provides the complete NPI Profile along with additional information for Abdul Qazi, a provider established in Plymouth, Indiana with a medical specialization in Hospitalist and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1366508228 assigned on December 2006. The practitioner's primary taxonomy code is 208M00000X with license number 01079521A (IN). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1366508228
Provider Name
ABDUL SAMI QAZI M.D.
Gender
Male
Entity Type
Individual
Location Address
1915 LAKE AVE PLYMOUTH, IN 46563
Location Phone
(574) 948-4000
Location Fax
(574) 948-5454
Mailing Address
5218 BECK DR STE 12 ELKHART, IN 46516
Mailing Phone
(574) 335-7700
Medical School Name
OTHER
Graduation Year
1999
Is Sole Proprietor?
No
Enumeration Date
12-28-2006
Last Update Date
07-14-2021
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Location Map

Secondary Locations

  • 513 3rd St SW
    Wagner, SD 57380
    (605) 384-3418

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
01079521A
License State
IN
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

01079521A (IN)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
000001142877OTHER (01)INBCBS
300009791MEDICAID (05)IN 

Medicare Participation & PECOS Enrollment Status

Abdul Qazi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Abdul Qazi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8022110287

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180112001357

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 345 times for 193 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 392 times for 174 patients

Follow-up observation care per day, typically 25 minutes

Follow-up observation care is a daily service where your health progress is monitored for about 25 minutes. It's a routine check to ensure your treatment is effective and to adjust if necessary. It's a crucial part of your healthcare journey.

This service was performed 15 times for 12 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 11 times for 11 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 222 times for 206 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 24 times for 24 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 128 times for 122 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 15 times for 15 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 46563 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $122.49
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $30.62
  • Minimum New Patient Copayment $13.26
  • Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.22
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $23.55
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $33.05

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Abdul Qazi is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
JOHNSON MEMORIAL HOSPITAL1125 W JEFFERSON ST
FRANKLIN, IN 46131
(317) 736-3300Acute Care Hospitals
NORTHWEST HEALTH-LA PORTE1331 STATE STREET
LA PORTE, IN 46350
(219) 326-1234Acute Care Hospitals
REID HEALTH1100 REID PKWY
RICHMOND, IN 47374
(765) 983-3000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1366508228, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
6
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
2
Unchanged
Pos 9
2
Doubled → 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 8 → 16 → 7 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 2 + 6 + 1 + 0 + 0 + 1 + 6 + 2 + 4 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1366508228.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Specialist/Technologist (Athletic Trainer)
1915 LAKE AVE
PLYMOUTH, IN 46563
Dietitian, Registered
1915 LAKE AVE
PLYMOUTH, IN 46563
Occupational Therapy Assistant
1915 LAKE AVE
PLYMOUTH, IN 46563
Dietitian, Registered
1915 LAKE AVE
PLYMOUTH, IN 46563
Internal Medicine (Hematology & Oncology)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Radiology (Radiation Oncology)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Radiology (Radiation Oncology)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Emergency Medicine
1915 LAKE AVE
PLYMOUTH, IN 46563
Family Medicine
1915 LAKE AVE
PLYMOUTH, IN 46563
Internal Medicine
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Emergency Medicine
1915 LAKE AVE
PLYMOUTH, IN 46563
Internal Medicine (Medical Oncology)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Practitioner (Family)
1915 LAKE AVE
PLYMOUTH, IN 46563
Nurse Anesthetist, Certified Registered
1915 LAKE AVE
PLYMOUTH, IN 46563

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366508228, enumerated as an "individual" on December 28, 2006.

The provider is located at 1915 LAKE AVE PLYMOUTH, IN 46563 and the phone number is (574) 948-4000.

Hospitalist with taxonomy code 208M00000X.

The provider might be accepting Accepts: CareSource, Blue Cross Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.

Abdul Qazi is affiliated with: JOHNSON MEMORIAL HOSPITAL, NORTHWEST HEALTH-LA PORTE and REID HEALTH.