Active NPI
James A Serwatka, MD
- Family Medicine Physician
- La Porte, IN
National Provider Identifier
1053453365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01023702A
- Practice address
- 400 Teagarden
Community Health Center
La Porte, IN 46350 - Phone
- (219) 326-0043
- Fax
- (219) 326-8909
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01023702A | IN | Primary |
Addresses
Primary practice location
400 Teagarden
Community Health Center
La Porte, IN 46350
Mailing address
1007 Lincolnway
Post Office Box 1539
La Porte, IN 46350-3201
Phone (219) 326-0043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100092150A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01023702A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health la Porte Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- La Porte, IN
- NPI 1386822989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1053453365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 LINCOLNWAY",
"address_2": "POST OFFICE BOX 1539",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463503201",
"telephone_number": "219-326-0043",
"fax_number": "219-326-8909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 TEAGARDEN",
"address_2": "COMMUNITY HEALTH CENTER",
"city": "LA PORTE",
"state": "IN",
"postal_code": "46350",
"telephone_number": "219-326-0043",
"fax_number": "219-326-8909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERWATKA",
"first_name": "JAMES",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01023702A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100092150A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Porte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.