Individual provider Active NPI

Kristina Wu, M.D.

  • Pulmonary Disease Physician
  • Michigan City, IN
National Provider Identifier
1114998275
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01046617A Issued in IN
Practice address
1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone
(219) 879-6531
Fax
(219) 873-2988
NPI assigned
Jan 27, 2006
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01046617A IN Primary

Addresses

Primary practice location

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Mailing address

1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone (219) 879-6531

Other practice location 1

1007 Lincolnway
LA Porte, IN 46350-3201
Phone (219) 326-1234

Other identifiers 1

IdentifierTypeStateIssuer
200143840MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000678 IN Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1052383437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Northwestern University Feinberg Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Practice addresses (Care Compare)

104 E Culver Rd
Knox, IN 46534-2241

1331 State St
La Porte, IN 46350-3112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046617AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Porte Clinic Company LLC CurrentSince Jul 1, 2020 Accepting new patients
La Porte Clinic Company LLC CurrentSince Jul 1, 2020 Accepting new patients
Healthpartners Medical Group, LLC Past Accepting new patients
Dunes Optical, LLC Past Accepting new patients
St Anthony Medical Center Past Accepting new patients
Medical Group Surgery Center LLC Past Accepting new patients

Locations

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

1007 Lincolnway
Laporte, IN 46350
Phone (219) 325-5474

1331 State St
Laporte, IN 46350
Phone (219) 326-2415

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1114998275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-879-6531",
            "fax_number": "219-873-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-879-6531",
            "fax_number": "219-873-2988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Lincolnway",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463503201",
            "country_code": "US",
            "telephone_number": "219-326-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "KRISTINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01046617A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200143840",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.