Uchicago Medicine Northwest Indiana Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

UCHICAGO MEDICINE NORTHWEST INDIANA INC

Practice address

10855 Virginia St Ste 1200
Crown Point, IN 46307-0210

Phone

(999) 999-9999

NPI assigned

Jul 12, 2023

Last updated

Jan 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Fountain

Title

VP Revenue Cycle

Phone

(773) 834-5895

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Uchicago Medicine Northwest Indiana Inc

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1144914532

  2860831781

  Same PAC ID

Listed as

Uchicago Medicine Northwest Indiana IncCCN 15C0002017

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Uchicago Medicine Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Uchicago Medicine Northwest Indiana Inc

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1144914532
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Home Infusion Therapy Pharmacy
  • Calumet City, IL
  • NPI 1942999073

  Member Of

  NPD member
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786

  Member Of

  NPD member

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1306525837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965",
            "telephone_number": "773-795-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10855 VIRGINIA ST STE 1200",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070210",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCHICAGO MEDICINE NORTHWEST INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "773-834-5895"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Mae Tuma, PA-C
• Michelle Joy Tupas, PT
• Dajah Turner, RBT
• Dwight S Tyndall, MD
• Uchicago Medicine Northwest Indiana Inc
• Mohammad Nizam Uddin, MD
• Jennifer L Uhl, LCSW
• Ultimate Rehab Services
• Danette Pacana Unabia, REGISTERED NURSE
• Makayla Catera Underwood

• Ambulatory Surgical Clinic/Center in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.