Organization Active NPI

Northwest Indiana Neurological Associates, PC

  • Neurology Physician
  • Munster, IN
National Provider Identifier
1104820083
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01030711A Issued in IN
Legal business name
NORTHWEST INDIANA NEUROLOGICAL ASSOCIATES, PC
Practice address
801 Macarthur Blvd
Ste 404
Munster, IN 46321-2919
Phone
(219) 836-2995
Fax
(219) 836-4075
NPI assigned
Jun 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Authorized official

Name
Dr. David S Rozenfeld, M.D
Title
President/Ceo
Phone
(219) 836-2995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 01030711A IN Primary

Addresses

Primary practice location

801 Macarthur Blvd
Ste 404
Munster, IN 46321-2919

Mailing address

801 Macarthur Blvd
Ste 404
Munster, IN 46321-2919
Phone (219) 836-2995

Other identifiers 1

IdentifierTypeStateIssuer
100169190MedicaidIN

National Provider Directory

National Provider Directory

Locations

801 MacArthur Blvd
Ste 404
Munster, IN 46321
Phone (219) 836-2995

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1104820083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD",
            "address_2": "STE 404",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212919",
            "telephone_number": "219-836-2995",
            "fax_number": "219-836-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD",
            "address_2": "STE 404",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212919",
            "telephone_number": "219-836-2995",
            "fax_number": "219-836-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA NEUROLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "ROZENFELD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "219-836-2995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01030711A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100169190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.