NORTHWEST INDIANA PODIATRY CLINIC, LLC (NPI# 1609072677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609072677 |
| Entity Type | Organization |
| Organization Name | NORTHWEST INDIANA PODIATRY CLINIC, LLC |
| Practice Address |
3100 45th Ave Highland IN 46322 |
| Mailing Address |
9933 S Western Ave Suite 102 Chicago IL 60643-1810 |
| Practice Telephone | 2199220510 |
| Practice Fax Number | 2199234594 |
| Mailing Telephone | 7734453800 |
| Mailing Fax Number | 7732332513 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2009-11-12 |
| Authorized Official Name | DR. FORTUNEE MASSUDA (MEDICAL DIRECTOR & CEO) |
| Authorized Official Telephone | 7732333800 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 211D00000X | Assistant, Podiatric | Podiatric Medicine & Surgery Service Providers | ||
| N | 213E00000X | Podiatrist | IN | Podiatric Medicine & Surgery Service Providers | |
| N | 213EP0504X |
Podiatrist Specialization: Public Medicine |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200124730C | 05 | |
| IN | BCBS NUMBER | 90001145 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801888359 | Northwest Indiana Podiatry Clinic, LLC | Podiatrist | 4320 Fir St, East Chicago, IN 46312-3052 | 2005-08-19 |
| 1932305117 | Northwest Indiana Podiatry Clinic, LLC | Assistant, Podiatric | 9134 Columbia Ave, Suite B, Munster, IN 46321-2907 | 2007-06-25 |
| 1922204106 | Northwest Indiana Podiatry Clinic, LLC | Podiatrist | 7250 Arthur Blvd, Merrillville, IN 46410-3766 | 2007-06-25 |
| 1639375058 | Northwest Indiana Podiatry Clinic, LLC | Podiatrist | 1534 119th St, Whiting, IN 46394-1733 | 2007-06-22 |
| Street Address |
3100 45TH AVE |
| City | HIGHLAND |
| State | IN |
| Zip Code | 46322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431733 | Marielva Banks | Physician Assistant | 10343 Indianapolis Blvd Ste 104, Highland, IN 46322 | 2017-08-03 |
| 1467806596 | Archangel Home Care Inc | Home Health | 2148 45th Ste 205, Highland, IN 46322 | 2016-04-14 |
| 1427457886 | Veronica Addison | Community/Behavioral Health | 219 Indianapolis Blvd, Ste B, Highland, IN 46322 | 2014-08-21 |
| 1750700423 | Persa Darnell | Nurse Practitioner | 3747 45th Ave., Highland, IN 46322 | 2014-04-10 |
| 1043648207 | Wahbi Adad | Specialist | 8732 Woodward Ave, Highland, IN 46322 | 2013-10-28 |
| 1619229317 | Cleotis White | Counselor | 2646 Highway Ave Ste 108, Highland, IN 46322 | 2012-10-05 |
| 1912278904 | Noble Home Health Care LLC | Home Health | 2449 45th St, Suite D, Highland, IN 46322 | 2012-01-23 |
| 1891926531 | Saket B Sinha | Internal Medicine | 9030 Cline Ave, Highland, IN 46322 | 2009-07-29 |
| 1194998963 | Affordable Hearing Aid Center | Hearing Instrument Specialist | 2148 45th St, Highland, IN 46322 | 2008-04-11 |
| 1497954390 | Highland Clinic of Northwest Indiana Inc | General Practice | 2834 Highway Ave Ste 1, Highland, IN 46322 | 2007-07-12 |
| Find all providers in zip 46322 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235433715 | Podiatry Partners Inc | Podiatrist | 9105a Indianapolis Blvd Ste 102, Highland, IN 46322-2591 | 2010-12-27 |
| 1710114962 | Scott Steven Shelton | Podiatrist | 5455 W 11000 N Ste 203, Highland, UT 84003-8802 | 2009-06-15 |
| 1952309759 | George V. Tsoutsouris | Podiatrist | 9105a Indianapolis Blvd, Suite 102, Highland, IN 46322-2591 | 2005-07-14 |
| 1477737054 | Gitersonke Foot Clinic, PC | Podiatrist | 1520 9th St, Suite 240, Highland, IL 62249-1677 | 2007-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356853873 | Hoosier Foot & Ankle LLC | Podiatrist | 7412 Rockville Rd Ste A, Indianapolis, IN 46214-3098 | 2017-10-25 |
| 1952830499 | Britney Ann Wenig | Podiatrist | 10122 E 10th St Ste 250, Indianapolis, IN 46229-2663 | 2017-06-08 |
| 1952846776 | Veronica Alexis Kacmar-fedorchak | Podiatrist | 3215 Willowcreek Rd, Portage, IN 46368-5013 | 2017-01-03 |
| 1629529029 | Associated Surgeons and Physicians, LLC | Podiatrist | 7920 W. Jefferson Blvd., Ste. 230, Fort Wayne, IN 46804-4166 | 2016-10-20 |
| 1902359714 | Aamir Mahmood | Podiatrist | 10176 W 400 N Ste D, Michigan City, IN 46360-9009 | 2016-07-28 |
| 1437508116 | Brian K. Penrose | Podiatrist | 611 E Douglas Rd Ste 101, Mishawaka, IN 46545-1464 | 2016-06-03 |
| 1558756023 | Sarah Standish | Podiatrist | 1001 Hadley Rd Ste 105, Mooresville, IN 46158-1884 | 2015-04-01 |
| 1467872796 | William Joseph Edward Adams | Podiatrist | 1 Memorial Sq Ste 2100, Greenfield, IN 46140-1380 | 2014-04-25 |
| 1720406564 | Rachel Chhiba | Podiatrist | 9240 N Meridian St Ste 260, Indianapolis, IN 46260 | 2014-03-30 |
| 1245679802 | Ansgar Steven Olsen | Podiatrist | 360 Plaza Dr Ste B, Columbus, IN 47201-2960 | 2013-06-17 |
| Find all providers with the same taxonomy | ||||
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| 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.