Edgewater Systems For Balanced Living, Inc. - Medicare Mental Health Clinic in Gary, IN

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Edgewater Systems For Balanced Living, Inc. is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Gary, Indiana. The current practice location for Edgewater Systems For Balanced Living, Inc. is 1100 W 6th Ave, Gary, Indiana. For appointments, you can reach them via phone at (219) 885-4264. The mailing address for Edgewater Systems For Balanced Living, Inc. is 1100 W 6th Ave, Gary, Indiana and phone number is (219) 885-4264.

Edgewater Systems For Balanced Living, Inc. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1588705784. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (219) 885-4264.

Contact Information

Edgewater Systems For Balanced Living, Inc.
1100 W 6th Ave
Gary
IN 46402-1711
(219) 885-4264
(219) 882-0242

Map and Direction


Mental Health Clinic Profile

Full NameEdgewater Systems For Balanced Living, Inc.
SpecialityClinic/Center
Location1100 W 6th Ave, Gary, Indiana
Authorized Official Name and PositionLunette Lashaun Lott (DIRECTOR ACCTS. RECEIVABLES)
Authorized Official Contact2198854264
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Edgewater Systems For Balanced Living, Inc.
1100 W 6th Ave
Gary
IN 46402-1711

Ph: (219) 885-4264		Edgewater Systems For Balanced Living, Inc.
1100 W 6th Ave
Gary
IN 46402-1711

Ph: (219) 885-4264

NPI Details:

NPI Number1588705784
Provider Enumeration Date02/09/2007
Last Update Date01/11/2019

Medicare PECOS Information:

Medicare PECOS PAC ID9234398397
Medicare Enrollment IDO20120308000405

Medical Identifiers

Medical identifiers for Edgewater Systems For Balanced Living, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588705784NPI-NPPES
100273230MedicaidIN
200079390MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
251S00000XCommunity/behavioral Health (* (Not Available))Secondary
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Edgewater Systems For Balanced Living, Inc. acts as a billing entity for following providers:
Provider NamePratima M Mehta
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780693341
PECOS PAC ID: 8325935364
Enrollment ID: I20040303000643
Provider NameRobert White
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1093723496
PECOS PAC ID: 3173572583
Enrollment ID: I20050112000841
Provider NameRoland Walker
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1891875647
PECOS PAC ID: 2062454820
Enrollment ID: I20050523001047
Provider NameCharles F Motley
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1316948789
PECOS PAC ID: 2365491982
Enrollment ID: I20050823000339
Provider NameSurendra Shah
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1528088689
PECOS PAC ID: 5890884928
Enrollment ID: I20071127000765
Provider NameDewnzar D Howard
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1912016759
PECOS PAC ID: 1153401088
Enrollment ID: I20080104000478
Provider NameKupusamy Umapathy
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1306842786
PECOS PAC ID: 1557386356
Enrollment ID: I20080729000743
Provider NameMichelle Breunig
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1881724730
PECOS PAC ID: 0143394718
Enrollment ID: I20080730000427
Provider NamePamela V Tran
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1447386131
PECOS PAC ID: 1951475227
Enrollment ID: I20080805000149
Provider NameDiane E Spoljoric
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134213028
PECOS PAC ID: 4880762624
Enrollment ID: I20081007000646
Provider NameGerri C Browning
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1699782318
PECOS PAC ID: 4981590031
Enrollment ID: I20090807000444
Provider NameDeborah L Mccullough
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1942216478
PECOS PAC ID: 1052453701
Enrollment ID: I20100119000678
Provider NameTonia S Amaloo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598996589
PECOS PAC ID: 9335278928
Enrollment ID: I20100519000708
Provider NameChiedu J Nchekwube
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790871341
PECOS PAC ID: 5294717609
Enrollment ID: I20111221000552
Provider NameMathew V Castelino
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1912970229
PECOS PAC ID: 8527051572
Enrollment ID: I20120224000000
Provider NameMohammad R Butt
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1881722833
PECOS PAC ID: 8820081870
Enrollment ID: I20120807000699
Provider NameSandra Renee Gates Manna
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124396072
PECOS PAC ID: 0749431203
Enrollment ID: I20121108000643
Provider NameJennifer Evans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063781532
PECOS PAC ID: 7315192705
Enrollment ID: I20130311000352
Provider NameChantal L Walker
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1508979725
PECOS PAC ID: 4284865494
Enrollment ID: I20140331002059
Provider NameTanya Marie Rogers
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1245506369
PECOS PAC ID: 4880635614
Enrollment ID: I20151104000477
Provider NameStephanie O Bandy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306224597
PECOS PAC ID: 0941511380
Enrollment ID: I20151124000620
Provider NameDouge Barthelemy
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1942313366
PECOS PAC ID: 7618910159
Enrollment ID: I20160127001804
Provider NameSheri Barnes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598849739
PECOS PAC ID: 3678853850
Enrollment ID: I20161205001387
Provider NameMarshall James
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1134179963
PECOS PAC ID: 6305858747
Enrollment ID: I20170307001919
Provider NameEmma Rogers
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1437499621
PECOS PAC ID: 8820039191
Enrollment ID: I20170614000898
Provider NameMelinda Jones-saah
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477078798
PECOS PAC ID: 2062778061
Enrollment ID: I20171108000053
Provider NameEdith A Jenkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982142527
PECOS PAC ID: 2365702784
Enrollment ID: I20180205000052
Provider NameBianca Chatman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831653690
PECOS PAC ID: 3274873781
Enrollment ID: I20190320001500
Provider NameDoris Fandohan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679038186
PECOS PAC ID: 1557603974
Enrollment ID: I20190503000868
Provider NameLakeysha Patrice Freeny
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336761576
PECOS PAC ID: 1658793096
Enrollment ID: I20200612000561
Provider NameApril Donald
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083228399
PECOS PAC ID: 5991116253
Enrollment ID: I20201118001611
Provider NameLaresse Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013516939
PECOS PAC ID: 0648682583
Enrollment ID: I20201217000151
Provider NameSharon James
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1659385128
PECOS PAC ID: 6002873510
Enrollment ID: I20230420000482

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.