Individual provider Active NPI

Melissa M Dvorscak, NP

  • Family Nurse Practitioner
  • Chesterton, IN
National Provider Identifier
1023353174
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004259A Issued in IN
Practice address
3100 Village PT
Chesterton, IN 46304-9694
Phone
(219) 440-4835
Fax
(855) 220-2073
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28096838A IN
Family Nurse Practitioner 363LF0000X 71004259A IN Primary

Addresses

Primary practice location

3100 Village PT
Chesterton, IN 46304-9694

Mailing address

1 American SQ Ste 2610
Indianapolis, IN 46282-0004
Phone (317) 559-2055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131105001321 IN Practitioner - Nurse Practitioner 6507091279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28096838AINMDFamily Nurse Practitioner
71004259AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ourhealth Physicians Group, LLC CurrentSince Nov 1, 2023 Accepting new patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc Family CurrentSince May 6, 2021 Accepting new patients
Northshore Health Centers, Inc. CurrentSince May 6, 2021 Accepting new patients
Ourhealth Physicians Group, LLC Past Accepting new patients
Northshore Health Centers, Inc. PastSince Apr 1, 2021 Accepting new patients

Locations

3100 Village Pt
Chesterton, IN 46304
Phone (219) 395-1046

1 American Sq
Ste 2610
Indianapolis, IN 46282

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

9825 Wicker Ave
Saint John, IN 46373

1105 Cumberland Xing
Valparaiso, IN 46383
Phone (219) 256-5615

Interoperability endpoints

  • Direct secure messaging: melissa.dvorscak.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1023353174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AMERICAN SQ STE 2610",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462820004",
            "telephone_number": "317-559-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 VILLAGE PT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049694",
            "telephone_number": "219-440-4835",
            "fax_number": "855-220-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORSCAK",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28096838A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004259A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

Verify at the official NPI Registry.