Individual provider Active NPI

Brian Thomas Damitz, D.P.M.

  • Podiatrist
  • Chesterton, IN
National Provider Identifier
1033420534
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001184A Issued in IN
Practice address
601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone
(219) 921-1444
Fax
(219) 921-0533
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07001184A IN Primary

Addresses

Primary practice location

601 Gateway Blvd N
Chesterton, IN 46304-9658

Mailing address

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Other practice location 1

2501 Cumberland Dr
Valparaiso, IN 46383-2503
Phone (219) 921-1444

Other practice location 2

3691 Willowcreek Rd
Portage, IN 46368-5080
Phone (219) 921-1444

Other identifiers 1

IdentifierTypeStateIssuer
300011145MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address b.damitz@lbji.exscribedirect.com

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729002719 IN Practitioner - Podiatry 1355567215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, shared by 17 NPIs, 325 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

1300 Lincolnway
Valparaiso, IN 46383-5824

2501 Cumberland Dr
Valparaiso, IN 46383-2503
Phone (219) 921-1444

3691 Willowcreek Rd
Portage, IN 46368-5076
Phone (219) 921-1444

3777 N Frontage Rd
Suite 900
Michigan City, IN 46360-7698
Phone (219) 921-1444

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

500 E 109TH Ave
Crown Point, IN 46307-7294
Phone (219) 921-1444

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.8 of 100Reported as group
Quality
81.02
Improvement activities
40
Cost
74.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of nail tissue40
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001184AINMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: bdamitz230413@direct.franciscanalliance.org

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 4

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1033420534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATEWAY BLVD N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049658",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GATEWAY BLVD N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049658",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-0533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Cumberland Dr",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832503",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3691 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685080",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMITZ",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001184A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300011145",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "b.damitz@lbji.exscribedirect.com",
            "affiliation": "N",
            "address_1": "601 Gateway Blvd N",
            "city": "Chesterton",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463049658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

Verify at the official NPI Registry.