NPIMap

Individual provider Active NPI

Vimal B Pathak, MD

  • Surgery Physician
  • Merrillville, IN
National Provider Identifier
1245290378
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01034936A Issued in IN
Practice address
1000 E 80TH Place
Suite 308 South Tower
Merrillville, IN 46410
Phone
(219) 736-8118
Fax
(219) 736-7583
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01034936A IN Primary

Addresses

Primary practice location

1000 E 80TH Place
Suite 308 South Tower
Merrillville, IN 46410

Mailing address

1000 E 80TH Place
Suite 308 South Tower
Merrillville, IN 46410
Phone (219) 736-8118

Other identifiers 1

IdentifierTypeStateIssuer
000000328376OtherINANTHEM BC/BS

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01034936AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Center of Northwest Indiana, LTD Past Accepting new patients
Vein Center of Northwest Indiana Past Accepting new patients
Vein Associates of Northwest Indiana LLC PastSince Mar 13, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12167/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1245290378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 80TH PLACE",
            "address_2": "SUITE 308 SOUTH TOWER",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-736-8118",
            "fax_number": "219-736-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 80TH PLACE",
            "address_2": "SUITE 308 SOUTH TOWER",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-736-8118",
            "fax_number": "219-736-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "VIMAL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01034936A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000328376",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.