NPIMap

Organization Active NPI

Northwest Indiana Nephrology PC

  • Nephrology Physician
  • Valparaiso, IN
National Provider Identifier
1285991885
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NORTHWEST INDIANA NEPHROLOGY PC
Practice address
2711 Leonard Dr Ste 101
Valparaiso, IN 46383-7121
Phone
(219) 462-6001
Fax
(219) 462-6060
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Authorized official

Name
Aj Pampalone, DONPI 1255337630
Title
President
Phone
(219) 836-2022

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2711 Leonard Dr Ste 101
Valparaiso, IN 46383-7121

Mailing address

2711 Leonard Dr Ste 101
Valparaiso, IN 46383-7121
Phone (219) 462-6001

Other identifiers 1

IdentifierTypeStateIssuer
201062390MedicaidIN

National Provider Directory

National Provider Directory

Locations

650 Dickinson Rd
Ste 2
Chesterton, IN 46304

4320 Fir St
Unit 202
East Chicago, IN 46312

1705 W 25th Ave
Ste 105
Gary, IN 46404

3229 Broadway
Ste 211
Gary, IN 46409
Phone (219) 981-2774

7 Sibley St
Hammond, IN 46320
Phone (219) 852-6121

222 Douglas St
Hammond, IN 46320
Phone (219) 852-6131

10120 Calumet Ave
Ste 103
Munster, IN 46321
Phone (219) 836-2936

801 MacArthur Blvd
Ste 202
Munster, IN 46321
Phone (219) 836-2936

3630 Willowcreek Rd
Ste 9
Portage, IN 46368
Phone (219) 220-2020

2711 Leonard Dr
#101
Valparaiso, IN 46383
Phone (219) 432-6001

Practitioners & affiliated clinicians

Practitioners 12

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": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1285991885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 LEONARD DR STE 101",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837121",
            "telephone_number": "219-462-6001",
            "fax_number": "219-462-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 LEONARD DR STE 101",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837121",
            "telephone_number": "219-462-6001",
            "fax_number": "219-462-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA NEPHROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "PAMPALONE",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-836-2022",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201062390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.