Maryam Jameelah Adisa

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02008985A Issued in IN

Practice address

751 E 81St Ave
Merrillville, IN 46410-5538

Phone

(219) 791-9389

NPI assigned

Apr 1, 2022

Last updated

Jul 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1134869522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105538",
            "telephone_number": "219-791-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105538",
            "telephone_number": "219-791-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADISA",
        "first_name": "MARYAM",
        "middle_name": "JAMEELAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02008985A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Addy, MD
• Olubunmi Adekugbe, D.M.D., M.P.H.
• Michael S. Adeleke, P.T.
• Adiel Home Health Services, LLC
• Fatai Bolaji Adisa, PT
• 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.

• Family Medicine Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.