SYED R. MUMTAZ (M.D.) – Child & Adolescent Psychiatry Physician, NPI 1396718573
Child & Adolescent Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
529 PSYCHIATRY in IN
Loading map...
Provider Addresses for SYED R. MUMTAZ (M.D.)
909, East State Boulevard, Fort Wayne, Allen County, Indiana, 46805, United States
FORT WAYNE, IN 468053404
Phone: (260) 481-2700
Fax: (260) 481-2717
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $87.
Total Amount is formed as General ($87) + Research ($0) + Ownership ($0) = $87.
Last reported payment date: 2024-08-15 • Largest payer in this snapshot: ABBVIE INC. ($22).
Total Amount
$87
General + Research + Ownership
Payments
5
Total payment records
General Amount
$87
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $22 |
| Otsuka America Pharmaceutical, Inc. | $19 |
| Ironshore Pharmaceuticals Inc. | $18 |
| Almatica Pharma LLC | $18 |
| Corium, LLC | $10 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040726000052 | I | Psychiatry | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 75 | 28 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 58 | 20 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 13 | 13 | $0 |
Insurance plans in this area (ZIP 46805)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Physician Assistant | OH | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | IN | |
| Internal Medicine | IN | |
| P S Y C H I A T R Y | IN | |
| Internal Medicine | IN | |
| Internal Medicine | OH | |
| Nurse Practitioner | VA | |
| Internal Medicine | IN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.