MEDICARE: MOHAMED HOMSI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	01065608	IN
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	01065608	IN
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	01065608A	IN
4	390200000X	Student in an Organized Health Care Education/Training Program	11012900A	IN
5	207RC0000X	Cardiovascular Disease Physician	01065608A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000821084	OTHER	IN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952569121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED HOMSI MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 RONALD REAGAN PKWY STE 100
Second Line	:
City	:	AVON
State	:	IN
Zip	:	46123-6913
Country	:	US
Telephone Number	:	317-944-5330
Fax Number	:	317-273-5988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	05/24/2025

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Directions to “ MOHAMED HOMSI MD” Practice Location

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