J.K.Kansal MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

01032298B Issued in IN

Legal business name

J.K.KANSAL MD PC

Practice address

8969 Broadway
Merrillville, IN 46410-7039

Phone

(219) 769-7761

Fax

(219) 769-0895

NPI assigned

Jul 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jatinder K Kansal I, M.D.

Title

President

Phone

(219) 769-7761

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Tax ID family

JK Kansal MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• J K Kansal MD PC

  • Allergy Physician
  • Merrillville, IN
  • NPI 1811131949
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• J K Kansal, M.D., P.C.

  • Specialist
  • Merrillville, IN
  • NPI 1033289129
  Medicare reassignment

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1104181692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8969 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107039",
            "telephone_number": "219-769-7761",
            "fax_number": "219-769-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8969 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107039",
            "telephone_number": "219-769-7761",
            "fax_number": "219-769-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.K.KANSAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "KANSAL",
        "authorized_official_first_name": "JATINDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-769-7761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01032298B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100169090B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Ivankovic, PHARMD
• Radosveta Georgieva Odiseeva Ivanova Nesch, M.D.
• Renee Ivy
• Augustine I Izah, MD
• J K Kansal MD PC
• Priasha Jachna, MED, BCBA
• Sha-Ron Jackson-Johnson, MD
• Danielle Jackson, APRN
• Felicia Jackson
• Krystle Starr Marie Jackson, RN

• Specialist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.