NPIMap

Organization Active NPI

Lakeshore Bone & Joint Institute, PC

  • Specialist
  • Portage, IN
National Provider Identifier
1194999896
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LAKESHORE BONE & JOINT INSTITUTE, PC
Practice address
3691 Willowcreek Rd
Portage, IN 46368-5076
Phone
(219) 921-1444
Fax
(219) 921-0533
NPI assigned
Apr 15, 2008
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Dr. Aaron G Anderson, MDNPI 1750584249
Title
President
Phone
(219) 921-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
Anesthesiology Physician 207L00000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Neurological Surgery Physician 207T00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Orthopaedic Hand Surgery Physician 207XS0106X NU
Orthopaedic Surgery of the Spine Physician 207XS0117X NU
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

3691 Willowcreek Rd
Portage, IN 46368-5076

Mailing address

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702000362 IN Part B Supplier - Clinic/Group Practice 3173500519 Receives reassigned benefits from 107 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chesterton, IN; Crown Point, IN; Michigan City, IN; Munster, IN; Portage, IN; Schererville, IN; Valparaiso, IN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

3777 N Frontage Rd
Ste 900
Michigan City, IN 46360
Phone (219) 877-3877

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1194999896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATEWAY BLVD N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049658",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3691 WILLOWCREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685076",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE BONE & JOINT INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-921-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.