Robert Kovachevich, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02002505A Issued in IN

Practice address

15900 W 101St Ave
Dyer, IN 46311

Phone

(219) 365-6333

Fax

(219) 365-8291

NPI assigned

Feb 13, 2006

Last updated

Apr 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  NPD (past)
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD (past)
• Illiana Surgery & Medical Center, LLC

  dba The Orthopedics Centers, LLC

  • Orthopaedic Surgery Physician
  • Merrillville, IN
  • NPI 1962401927
  NPD (past)
• St Anthony Medical Center

  dba Franciscan Physician Network

  • Multi-Specialty Clinic/Center
  • Crown Point, IN
  • NPI 1568402774
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1073587507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 W 101ST AVE",
            "address_2": "MARCOTTE MEDICAL GROUP, SC",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 W 101ST AVE",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-8291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16000 W 101st Ave",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "IN",
            "postal_code": "46311",
            "country_code": "US",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-8291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOVACHEVICH",
        "first_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-04-08",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002505A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000513385",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DE6640",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00462444",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200400350",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.kovachevich@mmgsc.eclinicaldirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15900 W 101st Ave",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey Lynn Killeen, M.A, CCC-SLP
• Stephen K Kimani, LCSW
• Angela Klukken, OT
• Heather Kmiecik, FNP-BC
• Kor Speech Therapy, LLC (Stacey Killeen)
• Catherine Kowalczyk, LCSW, LSSW
• Valari Anne Koziel, AU.D
• Kayla Marie Kralovec, NP
• Sonia Rae Krengel, PA
• Rebecca Krilich, FNP

• Family Medicine Physician in Dyer, IN
• Providers in Dyer, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.