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Contact Information

CARISSA L ASHTARY YAZDI, PA-C
5050 N CLINTON ST
FORT WAYNE, IN46825
 Phone: 260-484-8551
 Fax: 260-482-5060
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CARISSA L ASHTARY YAZDI · (Female)

NPI Number 1609224732
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 05/31/2016
Last updated 11/08/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 10002381A
  • IN Medicaid 300009169
Hospital affiliation(s)
  • LUTHERAN HOSPITAL OF INDIANA - (Acute Care)
    7950 W JEFFERSON BLVD
    FORT WAYNE, IN 46804
  • ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC - (Acute Care)
    11130 PARKVIEW CIRCLE DR
    FORT WAYNE, IN 46845
  • PARKVIEW REGIONAL MEDICAL CENTER - (Acute Care)
    11109 PARKVIEW PLAZA DRIVE
    FORT WAYNE, IN 46845
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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