| Lake Orthopedic And Spine | |
|
8550 Broadway Merrillville IN 46410-7173 | |
| (219) 795-1890 | |
| Not Available |
| Full Name | Lake Orthopedic And Spine |
|---|---|
| Speciality | Clinic/Center |
| Location | 8550 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Haroon Rashid Ansari (CEO) |
| Authorized Official Contact | 2197964103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Orthopedic And Spine 9301 Connecticut Dr Crown Point IN 46307-7486 Ph: (219) 756-2100 | Lake Orthopedic And Spine 8550 Broadway Merrillville IN 46410-7173 Ph: (219) 795-1890 |
| NPI Number | 1922546530 |
|---|---|
| Provider Enumeration Date | 02/02/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 1254331184 |
|---|---|
| Medicare Enrollment ID | O20080430000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922546530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kenya S Everette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205021268 PECOS PAC ID: 3072415496 Enrollment ID: I20040311000057 |
| Provider Name | Brett A Brechner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629079108 PECOS PAC ID: 6002887049 Enrollment ID: I20040804000103 |
| Provider Name | Brent A Jacobus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902807589 PECOS PAC ID: 2163494162 Enrollment ID: I20040810001164 |
| Provider Name | Patrick J Sheets |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396704268 PECOS PAC ID: 6608840327 Enrollment ID: I20040819001220 |
| Provider Name | Steven J Svabek |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114010279 PECOS PAC ID: 3476529207 Enrollment ID: I20040902001335 |
| Provider Name | Shreyas Arvind Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386646529 PECOS PAC ID: 2163472648 Enrollment ID: I20050124000578 |
| Provider Name | Billie A Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508837782 PECOS PAC ID: 7214978501 Enrollment ID: I20050517000745 |
| Provider Name | Donald L Pesavento |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104843937 PECOS PAC ID: 2264468867 Enrollment ID: I20050714000932 |
| Provider Name | Harry A Moffitt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669419776 PECOS PAC ID: 6406850767 Enrollment ID: I20070508000020 |
| Provider Name | Donald W Kucharzyk |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164499505 PECOS PAC ID: 2062409089 Enrollment ID: I20080714000160 |
| Provider Name | Linda S Holcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679733208 PECOS PAC ID: 2264509785 Enrollment ID: I20080925000591 |
| Provider Name | William Pierce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497838593 PECOS PAC ID: 7618077975 Enrollment ID: I20090408000459 |
| Provider Name | Arjun K Gupta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982664207 PECOS PAC ID: 9931170552 Enrollment ID: I20091211000466 |
| Provider Name | Merit D Lemke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467565218 PECOS PAC ID: 0345377701 Enrollment ID: I20100416000603 |
| Provider Name | Danny P Kaup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851370050 PECOS PAC ID: 3678638947 Enrollment ID: I20100602000172 |
| Provider Name | Ti-yon Emil Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841628047 PECOS PAC ID: 0941423123 Enrollment ID: I20140515000089 |
| Provider Name | Alexis Dunlap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588051726 PECOS PAC ID: 8628381431 Enrollment ID: I20150723007188 |
| Provider Name | Wendy Vottero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699141184 PECOS PAC ID: 8820305873 Enrollment ID: I20150923002245 |
| Provider Name | Tamer G Caleel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912213737 PECOS PAC ID: 9739498353 Enrollment ID: I20151022001048 |
| Provider Name | Sheilah Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871983833 PECOS PAC ID: 6002135928 Enrollment ID: I20160122001057 |
| Provider Name | Hayder H Jaffer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1326465725 PECOS PAC ID: 3678851250 Enrollment ID: I20170823003437 |
| Provider Name | Syed S Kazmi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154640902 PECOS PAC ID: 7416020565 Enrollment ID: I20180129000549 |
| Provider Name | Daniel Bermea |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760968101 PECOS PAC ID: 4385995604 Enrollment ID: I20180926002054 |
| Provider Name | Lisa Michelle Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720576986 PECOS PAC ID: 9032456389 Enrollment ID: I20190124003563 |
| Provider Name | Amanda Ann Aldana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124671813 PECOS PAC ID: 5395074504 Enrollment ID: I20190913001524 |
| Provider Name | Maher Fattouh |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1457309965 PECOS PAC ID: 4385639970 Enrollment ID: I20200428000150 |
| Provider Name | Bethany Correlli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497353973 PECOS PAC ID: 3274946033 Enrollment ID: I20210115001462 |
| Provider Name | Amber Marie Turpin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912579368 PECOS PAC ID: 7113323213 Enrollment ID: I20210914002850 |
| Provider Name | Rashid Ansari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265851091 PECOS PAC ID: 9032481460 Enrollment ID: I20221209000669 |
| Provider Name | Dorcas N Muiru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336856764 PECOS PAC ID: 2466822234 Enrollment ID: I20230112001610 |
Uwc- Merrillville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 W 81st Ave Ste A, Merrillville, IN 46410 Phone: 312-421-1016 Fax: 219-255-9588 | |
Solution Telehealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 W 58th Pl, Merrillville, IN 46410 Phone: 773-732-0816 | |
Northshore Merrillville Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6091 Broadway, Merrillville, IN 46410 Phone: 219-763-8944 Fax: 219-764-5395 | |
Proactive Md Merrillville Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 387 E 84th Dr, Merrillville, IN 46410 Phone: 812-645-1892 | |
Northshore Regional Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8555 Taft St, Merrillville, IN 46410 Phone: 219-763-8812 Fax: 219-764-3251 | |
Northshore Regional Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8555 Taft St, Merrillville, IN 46410 Phone: 219-763-8112 Fax: 219-764-3251 | |
Workcare Occupational Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 751 E 81st Place, Merrillville, IN 46410 Phone: 219-769-4400 |