Individual provider Active NPI

Lauren Dandurand, AGACNP-BC

  • Geriatric Medicine (Family Medicine) Physician
  • Merrillville, IN
National Provider Identifier
1295322642
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
71010539A Issued in IN
Practice address
200 E 89TH Ave Ste 2a
Merrillville, IN 46410-7319
Phone
(219) 736-2800
NPI assigned
Dec 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 71010539A IN Primary

Addresses

Primary practice location

200 E 89TH Ave Ste 2a
Merrillville, IN 46410-7319

Mailing address

200 E 89TH Ave Ste 2a
Merrillville, IN 46410-7319
Phone (219) 736-2800

Other practice location 1

929 Ridge Rd Ste 5
Munster, IN 46321-1769
Phone (219) 836-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ldandurand@geniusdoc.com Direct SUNITI MEDICAL CORPORATION

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210108001920 IN Practitioner - Nurse Practitioner 7214340371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71010539AINMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suniti Medical Corporation CurrentSince Jan 1, 2021 Accepting new patients
Suniti Medical Corporation CurrentSince Jan 1, 2021 Accepting new patients

Locations

200 E 89th Ave
Ste 2A
Merrillville, IN 46410
Phone (219) 736-2800

929 Ridge Rd
Ste 5
Munster, IN 46321
Phone (219) 836-2000

Organizations & group practices 2

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": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1295322642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 89TH AVE STE 2A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107319",
            "telephone_number": "219-736-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 89TH AVE STE 2A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107319",
            "telephone_number": "219-736-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Ridge Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463211769",
            "country_code": "US",
            "telephone_number": "219-836-2000",
            "fax_number": "219-836-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANDURAND",
        "first_name": "LAUREN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "71010539A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ldandurand@geniusdoc.com",
            "affiliation": "Y",
            "affiliationName": "SUNITI MEDICAL CORPORATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 EAST 89TH AVENUE",
            "address_2": "SUITE 2A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "country_code": "US",
            "postal_code": "464107319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.