Individual provider Active NPI

Shane Allen Santek, D.O.

  • Emergency Medicine Physician
  • Hammond, IN
National Provider Identifier
1063733038
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02004581A Issued in IN
Practice address
5454 Hohman Avenue
Hammond, IN 46320
Phone
(219) 932-2300
NPI assigned
Jun 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL
Emergency Medicine Physician 207P00000X 02004581A IN Primary

Addresses

Primary practice location

5454 Hohman Avenue
Hammond, IN 46320

Mailing address

812 Beaumont Drive
Apt 104
Naperville, IL 60540
Phone (269) 547-0661

Other identifiers 2

IdentifierTypeStateIssuer
02004581AOtherININ STATE LICENSE
02004581BOtherININ CSR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150504000843 IN Practitioner - Emergency Medicine 6608195201 Reassigns benefits to 1 organization
I20191002002328 MI Practitioner - Emergency Medicine 6608195201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians
Southwestern Michigan Emergency Services, PCGroup PAC ID 1456265891, 69 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141

601 John St
Kalamazoo, MI 49007-5341
Phone (269) 341-7654

940 John St
Kalamazoo, MI 49001-2857
Phone (269) 552-4266

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Michigan Emergency Services, PC CurrentSince Sep 23, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Jul 1, 2024 Accepting new patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Oct 31, 2023 Accepting new patients

Locations

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

24 Joliet St
Ste 101
Dyer, IN 46311
Phone (219) 864-2059

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

940 John St
Kalamazoo, MI 49001
Phone (269) 343-7296

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

Interoperability endpoints

  • Direct secure messaging: ssantek91775@direct.franciscanalliance.org

Organizations & group practices 3

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063733038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 BEAUMONT DRIVE",
            "address_2": "APT 104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540",
            "telephone_number": "269-547-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 HOHMAN AVENUE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "46320",
            "telephone_number": "219-932-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTEK",
        "first_name": "SHANE",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02004581A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN STATE LICENSE",
            "identifier": "02004581A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN CSR",
            "identifier": "02004581B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.