Jeremy Michaelis, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71011400A Issued in IN

Practice address

2323 Broadway St
East Chicago, IN 46312

Phone

(219) 354-8910

Fax

(219) 354-0900

NPI assigned

Aug 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.michaelis@healthlinc.directbygreenway.com

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.

• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1528262581
  Medicare reassignment Care Compare group NPD
• Healthlinc, Inc

  • Federally Qualified Health Center (FQHC)
  • Morocco, IN
  • NPI 1568354116
  NPD
• Healthlinc, Inc

  • Federally Qualified Health Center (FQHC)
  • South Bend, IN
  • NPI 1972071769
  NPD (past)

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

• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1689776882
  Care Compare affiliation

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1316611361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 STURDY RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463834126",
            "telephone_number": "219-462-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 BROADWAY ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "46312",
            "telephone_number": "219-354-8910",
            "fax_number": "219-354-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELIS",
        "first_name": "JEREMY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71011400A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Christopher McLain, BA
• Christiana Elise McLean, FNP-BC
• Angelica Seferina Medina
• Khushbu Mehta, OD
• Kimberly T Meyer, MD
• Paula M Minard
• Crusetia Mobley, R.N.
• Marcus Mobley
• Amira Faizana Mohammed
• Zorana Momirovich, PHARMD

• Nurse Practitioner in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.