Individual provider Active NPI

J K Kansal, M.D., P.C.

  • Specialist
  • Merrillville, IN
National Provider Identifier
1033289129
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
50005027 Issued in IN
Practice address
8969 Broadway
Merrillville, IN 46410-7039
Phone
(219) 769-7761
Fax
(219) 769-0895
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 50005027 IN Primary

Addresses

Primary practice location

8969 Broadway
Merrillville, IN 46410-7039

Mailing address

8969 Broadway
Merrillville, IN 46410-7039
Phone (219) 769-7761

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050505000119 IN Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4486694882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8969 Broadway
Merrillville, IN 46410-7039
Phone (219) 769-7761

Hospital & facility affiliations

  • Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50005027INMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
J K Kansal MD PC PastSince Aug 1, 2012 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233878400000",
    "number": "1033289129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8969 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107039",
            "telephone_number": "219-769-7761",
            "fax_number": "219-769-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8969 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107039",
            "telephone_number": "219-769-7761",
            "fax_number": "219-769-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANSAL",
        "first_name": "J",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "50005027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.