| Internal Medicine,geriatrics And Oncology Group, P.c. | |
|
2640 Hamstrom Rd Portage IN 46368-3832 | |
| (219) 762-9523 | |
| (219) 763-3120 |
| Full Name | Internal Medicine,geriatrics And Oncology Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2640 Hamstrom Rd, Portage, Indiana |
| Authorized Official Name and Position | Diana G Neumann (BILLING CLERK) |
| Authorized Official Contact | 2194644786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine,geriatrics And Oncology Group, P.c. 2640 Hamstrom Rd Portage IN 46368-3832 Ph: (219) 762-9523 | Internal Medicine,geriatrics And Oncology Group, P.c. 2640 Hamstrom Rd Portage IN 46368-3832 Ph: (219) 762-9523 |
| NPI Number | 1417983537 |
|---|---|
| Provider Enumeration Date | 06/23/2006 |
| Last Update Date | 07/18/2014 |
| Medicare PECOS PAC ID | 1153338348 |
|---|---|
| Medicare Enrollment ID | O20060313000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417983537 | NPI | - | NPPES |
| 200201230 | Medicaid | IN | |
| 100157480A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01027933A (Indiana) | Primary |
| Provider Name | Shreyas Arvind Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386646529 PECOS PAC ID: 2163472648 Enrollment ID: I20050124000578 |
| Provider Name | Gayle M Voight Block |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861799090 PECOS PAC ID: 2961688973 Enrollment ID: I20110509000453 |
| Provider Name | Havishakrishna Sarma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992934020 PECOS PAC ID: 9537323142 Enrollment ID: I20120612000208 |
| Provider Name | Christina D Vlamos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750739702 PECOS PAC ID: 8123312022 Enrollment ID: I20160815002023 |
| Provider Name | Ileana Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477042505 PECOS PAC ID: 8729334677 Enrollment ID: I20180706000783 |
| Provider Name | Shaleena M Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700553906 PECOS PAC ID: 4082002589 Enrollment ID: I20211103001322 |
Primary Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3125 Willowcreek Road, Portage, IN 46368 Phone: 219-762-3175 Fax: 219-763-3092 | |
Kota Medical Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3630 Willowcreek Rd, Portage, IN 46368 Phone: 219-759-5812 Fax: 219-759-5890 | |
Willow Creek Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3156 Willowcreek Rd, Portage, IN 46368 Phone: 219-762-4999 Fax: 219-762-2288 | |
New Beginnings Suboxone Treatment, Llc Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2640 Hamstrom Rd, Portage, IN 46368 Phone: 219-762-4423 | |
Ranga Kota Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3630 Willowcreek Rd, Portage, IN 46368 Phone: 219-759-5812 | |
Healtheaccess Clinics L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6615 S Boundary Rd, Portage, IN 46368 Phone: 219-787-8662 |