Individual provider Active NPI

Miyako S Streeter, FNP

  • Family Nurse Practitioner
  • Hammond, IN
National Provider Identifier
1225501356
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041358443 Issued in IL
Practice address
31 Sibley St Ste a
Hammond, IN 46320
Phone
(219) 802-8800
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.017998 IL
Family Nurse Practitioner 363LF0000X 71008683A IN
Family Nurse Practitioner 363LF0000X 041358443 IL Primary

Addresses

Primary practice location

31 Sibley St Ste a
Hammond, IN 46320

Mailing address

31 Sibley St Ste a
Hammond, IN 46320-1725
Phone (219) 802-8800

Other practice location 1

5521 W Lincoln Hwy Ste 1A
Crown Point, IN 46307-1098
Phone (219) 769-1362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190116002967 IN Practitioner - Nurse Practitioner 0749526481 Reassigns benefits to 2 organizations
I20191023000097 IL Practitioner - Nurse Practitioner 0749526481 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.017998ILMDNurse Practitioner
041358443ILMDFamily Nurse Practitioner
71008683AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Emergency Services Physician Group CurrentSince Mar 18, 2024 Accepting new patients
Family Doc, Inc. CurrentSince May 1, 2020 Accepting new patients
Mea Chicago PC Nurse Practitioner CurrentSince Nov 1, 2022 Accepting new patients
Nwi Urgent Care, LLC CurrentSince Jan 10, 2019 Accepting new patients
Familydoc Urgent Care LLC CurrentSince Sep 14, 2019 Accepting new patients
The Methodist Hospitals, Inc PastSince Jan 10, 2019 Accepting new patients

Locations

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

7201 S Stony Island Ave
Chicago, IL 60649
Phone (773) 690-5300

5521 W US Highway 30
Ste 1A
Crown Point, IN 46307
Phone (219) 769-1362

31 Sibley St
Ste A
Hammond, IN 46320
Phone (219) 802-8800

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1225501356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SIBLEY ST STE A",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201725",
            "telephone_number": "219-802-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SIBLEY ST STE A",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "46320",
            "telephone_number": "219-802-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5521 W Lincoln Hwy Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463071098",
            "country_code": "US",
            "telephone_number": "219-769-1362",
            "fax_number": "219-769-8298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREETER",
        "first_name": "MIYAKO",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.017998",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008683A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041358443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

Verify at the official NPI Registry.