NPIMap

Organization Active NPI

Munster Medical Research Foundation Inc

Doing business as Community Hospital

  • General Acute Care Hospital
  • Munster, IN
National Provider Identifier
1003918210
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
05-005108-1 Issued in IN
Legal business name
MUNSTER MEDICAL RESEARCH FOUNDATION INC
Doing business as
Community Hospital
Practice address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone
(219) 836-1600
Fax
(219) 934-8889
NPI assigned
Sep 1, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Mrs. Char Kullerstrand
Title
Regional Director
Phone
(219) 934-8999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 05-005108-1 IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2901

Mailing address

PO Box 3602
Munster, IN 46321-0756
Phone (219) 934-8888

Other names 1

  • Community Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040623000905 IN Part B Supplier - Clinic/Group Practice 8123913183 Receives reassigned benefits from 2 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Munster, IN
O20050901000138 IN Part A Provider - Hospital 8123913183 Practice locations: Munster, IN; Schererville, IN; Saint John, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003918210. Details of each certification follow.

Hospital certification: CCN 150125

Legal name
MUNSTER MEDICAL RESEARCH FOUNDATION INC
Doing business as
COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 3, 1973
Last certification
Aug 19, 2004
Beds
437
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 3, 1973 in IN
Enrollment address
901 Macarthur Blvd
Munster, IN 46321-2901
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Community HospitalCCN 150125 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Networks

  • IL HMO C-SNP

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bruce R Yalowitz Individual Corporate DirectorDirector Jul 1, 2019
Steve Pestikas Individual Corporate Director Jul 1, 2013
Steven Chovanec Individual Corporate Director Jul 1, 2004
David Bochnowski Individual Corporate DirectorBod Treasurer Jul 1, 1990
Frankie Fesko Individual Corporate Director Jul 1, 1982
Michael Purcell Individual Corporate Director Jul 1, 2016
Constantine Dovellos Individual Corporate DirectorDirector Jul 1, 2020
Michael Mellon Individual Corporate Director Jul 1, 2016
Ingrid Wolf Individual Corporate DirectorDirector Jul 1, 2020
David Wickland Individual Corporate DirectorBod President Jul 1, 1991
Raymond Arthur Neiswonger Individual Corporate OfficerChief Executive Officer Jul 9, 2022
W-2 Managing Employee Jul 9, 2022
Daniel O'Brien Individual Corporate OfficerChief Financial Officer Jul 5, 2016
W-2 Managing Employee Jul 5, 2016
Nitin S Sardesai Individual Corporate Director Jul 1, 2008
Sandi Merlo Individual Corporate DirectorDirector Dec 1, 2021
Amy Han Individual Corporate Director Jul 1, 2022
Community Foundation of Northwest Indiana, Inc Organization, Munster, IN Non-profit 5% Or Greater Direct Ownership Interest Jan 7, 1985 100%
Thomas Brubaker Individual Corporate Director Jul 1, 1990
Eric a Compton Individual Corporate DirectorBod Secretary Jul 1, 2016
Donald Fesko Individual Other Jul 1, 2016
William Hasse Individual Corporate Director Jul 1, 2008
M. Nabil Shabeeb Individual Corporate Director Jul 1, 1997
Donald Torrenga Individual Corporate Director Jul 1, 2009

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Home Health ServicesMunster, IN, CCN 157487 Home health agency Operational/Managerial Control (100%) Aug 1, 1996

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1,065

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,065

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1003918210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3602",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463210756",
            "telephone_number": "219-934-8888",
            "fax_number": "219-934-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-1600",
            "fax_number": "219-934-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSTER MEDICAL RESEARCH FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "KULLERSTRAND",
        "authorized_official_first_name": "CHAR",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "219-934-8999",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "05-005108-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.