Individual provider Active NPI

Eric Anthony Gonsiorowski

  • Student in an Organized Health Care Education/Training Program
  • Gary, IN
National Provider Identifier
1043023690
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3400 Broadway
Gary, IN 46408-1101
Phone
(888) 968-7486
NPI assigned
Jan 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3400 Broadway
Gary, IN 46408-1101

Mailing address

5916 Wildrose LN
Schererville, IN 46375-3547
Phone (219) 781-0318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260528001615 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 7113497439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1043023690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 WILDROSE LN",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463753547",
            "telephone_number": "219-781-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464081101",
            "telephone_number": "888-968-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSIOROWSKI",
        "first_name": "ERIC",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.