Individual provider Active NPI

Avraham Sharfman, PSYD

  • Clinical Psychologist
  • Munster, IN
National Provider Identifier
1154316966
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
200405508A Issued in IN
Practice address
7550 Hohman Ave
Ste 1200a
Munster, IN 46321-1060
Phone
(616) 532-8000
Fax
(616) 532-7230
NPI assigned
Sep 19, 2005
Last updated
Jul 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 200405508A IN Primary

Addresses

Primary practice location

7550 Hohman Ave
Ste 1200a
Munster, IN 46321-1060

Mailing address

PO Box 2007
Grand Rapids, MI 49501-2007
Phone (616) 532-8000

Other identifiers 2

IdentifierTypeStateIssuer
100165290MedicaidIN
90000854OtherILBCBSIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
200405508AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Margaret Mercy Healthcare Centers Past Accepting new patients
St Margaret Mercy Healthcare Centers Clinical Past Accepting new patients
St Margaret Mercy Healthcare Centers Past Accepting new patients
Franciscan Health Dyer & Hammond Past Accepting new patients
St Margaret Mercy Healthcare Centers Clinical Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1154316966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2007",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012007",
            "telephone_number": "616-532-8000",
            "fax_number": "616-532-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 HOHMAN AVE",
            "address_2": "STE 1200A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211060",
            "telephone_number": "616-532-8000",
            "fax_number": "616-532-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARFMAN",
        "first_name": "AVRAHAM",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "200405508A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165290",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "90000854",
            "state": "IL"
        }
    ],
    "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 Jul 25, 2011; 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.