NPIMap

Individual provider Active NPI

Andleeb S Bangash, MD

  • Clinical Cardiac Electrophysiology Physician
  • La Porte, IN
National Provider Identifier
1003093824
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
01081191A Issued in IN
Practice address
901 Lincolnway Ste 302
La Porte, IN 46350-3429
Phone
(219) 324-0014
Fax
(219) 324-0025
NPI assigned
Jan 23, 2008
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 45920 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 45920 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 01081191A IN Primary

Addresses

Primary practice location

901 Lincolnway Ste 302
La Porte, IN 46350-3429

Mailing address

1050 Elm Creek Dr
Elmhurst, IL 60126-5204
Phone (414) 350-1696

Other practice location 1

600 Highland Ave
Aurora Sinai Medical Center
Madison, WI 53792-0001
Phone (608) 263-1530

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Andleeb.Bangash@laportehosp.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190130002665 IN Practitioner - Cardiovascular Disease (Cardiology) 8729277157 Reassigns benefits to 2 organizations
I20240229001547 TX Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 8729277157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ccmma SC LLCGroup PAC ID 7911242201, 17 clinicians

Practice addresses (Care Compare)

2441 Murray St
Chesterton, IN 46304-3557
Phone (845) 702-2711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45920WIMDCardiovascular Disease Physician
01081191AINMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ccmma SC LLC CurrentSince Dec 1, 2023 Accepting new patients
La Porte Clinic Company LLC CurrentSince Jan 1, 2019 Accepting new patients
La Porte Clinic Company LLC Cardiovascular Disease CurrentSince Jan 1, 2019 Accepting new patients
Ccmma NJ LLC PastSince Oct 28, 2025 Accepting new patients

Locations

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

901 Lincolnway
Ste 302
Laporte, IN 46350
Phone (219) 324-0014

120 N Delaware St
Sandusky, MI 48471
Phone (810) 648-3770

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: abangash1281986@direct.sw.org
  • Direct secure messaging: andleeb.bangash@laportehosp.cernerdirect.com
  • FHIR API: https://fhir-usa.unify.chbase.com/org/mckenzi-dd6edea8

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1003093824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 ELM CREEK DR",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265204",
            "telephone_number": "414-350-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LINCOLNWAY STE 302",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503429",
            "telephone_number": "219-324-0014",
            "fax_number": "219-324-0025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_2": "Aurora Sinai Medical Center",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-1530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGASH",
        "first_name": "ANDLEEB",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "45920",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "45920",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IN",
            "license": "01081191A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Andleeb.Bangash@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "901 Lincolnway Ste 302",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463503429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.