<unavail> in Gary, IN - Medicare Family Medicine

is a medicare enrolled primary clinic (Family Medicine) in Gary, Indiana. The current practice location for is 1619 W 5th Ave, Gary, Indiana. For appointments, you can reach them via phone at (219) 886-4788. The mailing address for is Po Box 4787, Gary, Indiana and phone number is (219) 886-4788.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1407985971. 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) 886-4788.

Contact Information


	1619 W 5th Ave Gary IN 46404-1506
	(219) 886-4788
	(219) 886-4106

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Family Medicine
Location	1619 W 5th Ave, Gary, Indiana
Authorized Official Name and Position	Nathaniel Ross (MEDICAL DIRECTOR)
Authorized Official Contact	2198864788
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 4787 Gary IN 46404-0787 Ph: (219) 886-4788	1619 W 5th Ave Gary IN 46404-1506 Ph: (219) 886-4788

NPI Details:

NPI Number	1407985971
Provider Enumeration Date	03/02/2007
Last Update Date	05/17/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	3870559966
Medicare Enrollment ID	O20090810000207

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407985971	NPI	-	NPPES
100212420A	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (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. acts as a billing entity for following providers:

Provider Name	Nathaniel T Ross
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1417942707 PECOS PAC ID: 6709808264 Enrollment ID: I20060119000500

Provider Name	Jeanne M Kerr
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1790328094 PECOS PAC ID: 3173956281 Enrollment ID: I20191204000163

Provider Name	Shavon Davis
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1992479042 PECOS PAC ID: 6709282387 Enrollment ID: I20210907002429

Reviews and Comments

Family Medicine in Gary, IN

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- Medicare Primary Care in Gary, IN