Mycare Express Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MYCARE EXPRESS CLINIC LLC

Practice address

3608 W 80TH LN
Merrillville, IN 46410-5061

Phone

(219) 648-2786

Fax

(183) 391-4153

NPI assigned

Apr 7, 2020

Organization subpart

No

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

Authorized official

Name

Atimanaparampil N. Damodaran, MDNPI 1255394805

Title

Cfo

Phone

(574) 806-4938

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21280/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Atimanaparampil N. Damodaran, M.D.

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1255394805

  Internal Medicine

  NPD Authorized official

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1194354530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 W 80TH LN",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105061",
            "telephone_number": "219-648-2786",
            "fax_number": "219-648-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 W 80TH LN",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105061",
            "telephone_number": "219-648-2786",
            "fax_number": "183-391-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYCARE EXPRESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-07",
        "last_updated": "2022-01-18",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "DAMODARAN",
        "authorized_official_first_name": "ATIMANAPARAMPIL",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-806-4938",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8941233128",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Murphy, DPM
• Maddison Grace Murphy, PA
• Samantha Murphy
• Reginald Murray, RBT
• Margaret Musillami
• Winnie H Mycka, LCSW
• Myeyedr Optometry of Indiana, LLC
• Kevin Andre Myrie, M.D,
• N W Indiana Radiology Services, PC
• Sarah Nabors, FNP

• All providers in Merrillville, IN
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.