Maryam Jameelah Adisa
Individual provider Active NPI Family Medicine Physician · Merrillville, IN
NPI 1134869522 · NPPES record last updated Jul 6, 2026
Key facts
- NPI
- 1134869522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02008985A (IN)
- Practice address
- 751 E 81St Ave
Merrillville, IN 46410-5538 - Phone
- (219) 791-9389
- NPI assigned
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 02008985A | IN | Yes |
Addresses
Primary practice location
751 E 81St Ave
Merrillville, IN 46410-5538
Mailing address
751 E 81St Ave
Merrillville, IN 46410-5538
Phone (219) 791-9389
Other providers in Merrillville, IN
- Sophia Addy
- Olubunmi Adekugbe
- Michael S. Adeleke
- Adiel Home Health Services, LLC
- Fatai Bolaji Adisa
- Advance & Hold Healthcare PC
- Advanced Optix, LLC
- Advanced Pain Management & Anesthesiology, PC
- Affiliated Ankle and Foot Podiatry Clinic, P.C.
- Affordable Dentures & Implants - Merrillville II, P.C.
All providers in Merrillville, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.