Healthy Aging Enterprise, LLC
NPI 1417315102ActiveOrganization· Internal Medicine· Fishers, IN
Internal Medicine in Fishers, Indiana, registered in NPPES in February 2016. The authorized official on file is Marwan Mustaklem, M.D., Mbr. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417315102 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 9, 2016 |
| Last updated in NPPES | Feb 9, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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