CANCER CARE CONSULTANTS, PC (NPI# 1093040719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093040719 |
| Entity Type | Organization |
| Organization Name | CANCER CARE CONSULTANTS, PC |
| Practice Address |
8554 Broadway Merrillville IN 46410-7032 |
| Practice Telephone | 2197509581 |
| Practice Fax Number | 2197509781 |
| Mailing Telephone | 2197509581 |
| Mailing Fax Number | 2197509781 |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2017-10-05 |
| Authorized Official Name | DR. BALAGOPAL KERALAVARMA (OWNER) |
| Authorized Official Telephone | 2197424237 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
01052677A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BSIL | 90001550 | 01 |
| IN | 201001720A | 05 |
| Street Address |
8554 BROADWAY |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-7032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801849997 | Mahendra M Shah | Internal Medicine | 8554 Broadway, Merrillville, IN 46410-7032 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194986703 | Brian Christopher Myre | Internal Medicine | 6111 Harrison St Ste 200, Merrillville, IN 46410-2972 | 2008-06-17 |
| 1801849997 | Mahendra M Shah | Internal Medicine | 8554 Broadway, Merrillville, IN 46410-7032 | 2006-05-18 |
| 1386612687 | Pimpa J Tara | Internal Medicine | 8127 Merrillville Rd, Merrillville, IN 46410-6158 | 2006-03-10 |
| 1609071349 | Alan Tan | Internal Medicine | 200 E 89th Ave, Suite 2a, Merrillville, IN 46410-7318 | 2007-06-20 |
| 1518035369 | Geeta Kurra | Internal Medicine | 200 E 89th Ave, Suite 2a, Merrillville, IN 46410-7318 | 2006-12-01 |
| 1013985258 | Virginia Tan Tabib | Internal Medicine | 8127 Merrillville Rd, Merrillville, IN 46410-6158 | 2006-03-14 |
| 1649257650 | Bharat H. Barai | Internal Medicine | 200 E 89th Ave, Suite 2a, Merrillville, IN 46410-7319 | 2005-12-30 |
| 1396722328 | Marion A. Trybula | Internal Medicine | 200 E 89th Ave, Suite 2a, Merrillville, IN 46410-7319 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134728553 | Infusion Center of Indiana LLC | Internal Medicine | 2150 Intelliplex Dr Ste 134b, Shelbyville, IN 46176-8550 | 2020-10-19 |
| 1659987832 | Vida Oncology LLC | Internal Medicine | 2150 Intelliplex Dr Ste 134, Shelbyville, IN 46176-8550 | 2020-09-22 |
| 1306256839 | Anne Catherine Meier | Internal Medicine | 1600 S Lake Park Ave Ste 1101, Hobart, IN 46342-6641 | 2014-05-06 |
| 1033451083 | Richard Brian Gaynor | Internal Medicine | Eli Lilly and Company Corporate Ctr, Indianapolis, IN 46285-0001 | 2013-03-17 |
| 1851697536 | Melhem Jabbour | Internal Medicine | 2723 S 7th St Ste O, Terre Haute, IN 47802-3562 | 2011-01-28 |
| 1760798326 | Redmond Prindiville Hogan IIi | Internal Medicine | 2808 W 44th St, Indianapolis, IN 46228-3147 | 2010-08-20 |
| 1720392798 | Mohammad Issam Abu Zaid | Internal Medicine | 535 Barnhill Drive, Rt 473, Indiana Univeristy/hematology Oncology, Indianapolis, IN 46202-5147 | 2010-08-02 |
| 1710112396 | Cancer Health Treatment Centers,p.c. | Internal Medicine | 104 Woodland Ct, Michigan City, IN 46360-7390 | 2009-05-26 |
| 1497998520 | Ashwin Kolala Vasudevamurthy | Internal Medicine | 8301 Harcourt Rd Ste 205, Indianapolis, IN 46260 | 2009-04-20 |
| 1386805307 | Vivian C Cook | Internal Medicine | 3699 Epworth Road, Newburgh, IN 47630-8909 | 2008-06-23 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
Please comment or provide details below to improve the information on CANCER CARE CONSULTANTS, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.