Individual provider Active NPI

Priti M Nuthakki

  • Gastroenterology Physician
  • Munster, IN
National Provider Identifier
1093957110
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01080501A Issued in IN
Practice address
701 Superior Ave Ste 2700
Munster, IN 46321-4037
Phone
(219) 934-9813
Fax
(219) 934-9823
NPI assigned
Apr 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036082683 IL
Internal Medicine Physician 207R00000X 01080501A IN
Gastroenterology Physician 207RG0100X 036082683 IL
Hepatology Physician 207RI0008X 036082683 IL
Transplant Hepatology Physician 207RT0003X 01080501A IN
Gastroenterology Physician 207RG0100X 01080501A IN Primary

Addresses

Primary practice location

701 Superior Ave Ste 2700
Munster, IN 46321-4037

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 1

IdentifierTypeStateIssuer
300015239MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pnuthakki399263@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20161011002696 IL Practitioner - Gastroenterology 0749580991 Reassigns benefits to 1 organization
I20180629001086 IN Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Other (Physician) 0749580991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

701 Superior Ave
Suite 2700
Munster, IN 46321-4037
Phone (219) 922-7168

Hospital & facility affiliations

  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165
  • Franciscan Health Dyer Hospital, Dyer, IN, CCN 150090
  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 17, 2016 Accepting new patients
Franciscan Physician Network Internal Medicine CurrentSince Jun 25, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Aug 17, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Franciscan Physician Network CurrentSince Jun 25, 2018 Accepting new patients

Locations

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

7732 Solutions Ctr
Chicago, IL 60677

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

701 Superior Ave
Ste 2700
Munster, IN 46321
Phone (219) 922-7168

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: pnuthakki399263@direct.franciscanalliance.org

Organizations & group practices 5

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 6

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": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1093957110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUPERIOR AVE STE 2700",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214037",
            "telephone_number": "219-934-9813",
            "fax_number": "219-934-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTHAKKI",
        "first_name": "PRITI",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036082683",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01080501A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036082683",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "IL",
            "license": "036082683",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "IN",
            "license": "01080501A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01080501A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015239",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pnuthakki399263@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 Superior Ave Ste 2700",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.