NPIMap

Organization Active NPI

Great Lakes Pulmonary & Sleep Associates, Inc

  • Pulmonary Disease Physician
  • Gary, IN
National Provider Identifier
1003096504
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01064140 Issued in IN
Legal business name
GREAT LAKES PULMONARY & SLEEP ASSOCIATES, INC
Practice address
650 Grant St Ste 7
Gary, IN 46404-1551
Phone
(219) 882-0255
Fax
(219) 738-6714
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Authorized official

Name
Olusegun Apata, MDNPI 1043298961
Title
Physician/Owner
Phone
(219) 882-0255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X 01064140 IN
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 01064140 IN Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X 01064140 IN

Addresses

Primary practice location

650 Grant St Ste 7
Gary, IN 46404-1551

Mailing address

PO Box 10068
Merrillville, IN 46411-0068
Phone (219) 882-0255

Other identifiers 1

IdentifierTypeStateIssuer
200881250AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071226000164 IN Part B Supplier - Clinic/Group Practice 4880784107 Receives reassigned benefits from 7 practitioners
Practice locations: Gary, IN; Merrillville, IN
O20131126001350 IL Part B Supplier - Clinic/Group Practice 4880784107 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2320 E 93rd St
Chicago, IL 60617
Phone (773) 967-2000

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1003096504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10068",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464110068",
            "telephone_number": "219-882-0255",
            "fax_number": "219-738-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 GRANT ST STE 7",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464041551",
            "telephone_number": "219-882-0255",
            "fax_number": "219-738-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PULMONARY & SLEEP ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "APATA",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "219-882-0255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01064140",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01064140",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "01064140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200881250A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.