NPIMap

Organization Active NPI

Midwest Neurology Associates PC

  • Neurology Physician
  • Dyer, IN
National Provider Identifier
1124453279
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01073001A Issued in IN
Legal business name
MIDWEST NEUROLOGY ASSOCIATES PC
Practice address
1100 Joliet St Ste 201
Dyer, IN 46311-1995
Phone
(219) 836-2096
Fax
(219) 836-2097
NPI assigned
Sep 9, 2013
Last updated
Jan 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Samer Kassar, M.D.NPI 1902839525
Title
Owner
Phone
(219) 836-2096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01073001A IN Primary

Addresses

Primary practice location

1100 Joliet St Ste 201
Dyer, IN 46311-1995

Mailing address

PO Box 423
Dyer, IN 46311-0423
Phone (219) 836-2096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131223000284 IN Part B Supplier - Clinic/Group Practice 3779710660 Receives reassigned benefits from 6 practitioners
Practice locations: Crown Point, IN; Dyer, IN; Munster, IN
O20180625001428 IL Part B Supplier - Clinic/Group Practice 3779710660 Receives reassigned benefits from 4 practitioners
Practice locations: Oak Brook, IL

National Provider Directory

National Provider Directory

Locations

2109 Northwinds Dr
Dyer, IN 46311
Phone (219) 402-0563

4321 Fir St
Ste 210
East Chicago, IN 46312
Phone (219) 392-7194

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1124453279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 423",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110423",
            "telephone_number": "219-836-2096",
            "fax_number": "219-836-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOLIET ST STE 201",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111995",
            "telephone_number": "219-836-2096",
            "fax_number": "219-836-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "KASSAR",
        "authorized_official_first_name": "SAMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-836-2096",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01073001A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.