Individual provider Active NPI

Jonathan Meyer, M.D.

  • Interventional Cardiology Physician
  • Munster, IN
National Provider Identifier
1285021758
Registry record updated Jul 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01089785A Issued in IN
Practice address
9104 Columbia Ave
Munster, IN 46321-2907
Phone
(219) 836-4473
Fax
(219) 703-6566
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036146463 IL
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 036146463 IL
Interventional Cardiology Physician 207RI0011X 01089785A IN Primary

Addresses

Primary practice location

9104 Columbia Ave
Munster, IN 46321-2907

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other identifiers 1

IdentifierTypeStateIssuer
300073859MedicaidIN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230713001746 IN Practitioner - Interventional Cardiology 7618286808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

9104 Columbia Ave
Munster, IN 46321-2907
Phone (219) 836-4473

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting85
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01089785AINMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Single Specialty CurrentSince Jul 24, 2023 Accepting new patients

Locations

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9038 Columbia Ave
Ste B
Munster, IN 46321
Phone (219) 836-5758

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

931 Fran Lin Pkwy
Munster, IN 46321
Phone (219) 513-0107

9104 Columbia Ave
Munster, IN 46321
Phone (219) 836-4473

505 W US Highway 30
Schererville, IN 46375
Phone (219) 322-3311

Interoperability endpoints

  • Direct secure messaging: jmeyer142786@ssdirect.comhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689379200000",
    "number": "1285021758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212907",
            "telephone_number": "219-836-4473",
            "fax_number": "219-703-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2023-07-15",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036146463",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036146463",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01089785A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300073859",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.