Individual provider Active NPI

Raylene Spisak

  • Primary Care Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1174478861
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
71017803A Issued in IN
Practice address
3903 E Lincoln Hwy
Merrillville, IN 46410-5810
Phone
(219) 736-0900
NPI assigned
Feb 27, 2026
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 71017803A IN Primary

Addresses

Primary practice location

3903 E Lincoln Hwy
Merrillville, IN 46410-5810

Mailing address

3903 E Lincoln Hwy
Merrillville, IN 46410-5810

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401001641 IN Practitioner - Nurse Practitioner 5890270409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3903 E US Hwy 30
Merrillville, IN 46410-5810

4065 Hendricks St
Gary, IN 46408-1820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71017803AINMDPrimary Care Nurse Practitioner

Organizations & group practices 1

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": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1174478861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 E LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 E LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105810",
            "telephone_number": "219-736-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPISAK",
        "first_name": "RAYLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71017803A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.