Individual provider Active NPI

Michael Knesek, MD

  • Orthopaedic Surgery Physician
  • Munster, IN
National Provider Identifier
1336376367
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
201328430 Issued in IN
Practice address
9445 Calumet Ave
Munster, IN 46321-2811
Phone
(219) 836-1060
Fax
(219) 836-1014
NPI assigned
Jun 17, 2009
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01075358B IN
Orthopaedic Surgery Physician 207X00000X 201328430 IN Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 201328430 IN

Addresses

Primary practice location

9445 Calumet Ave
Munster, IN 46321-2811

Mailing address

9445 Calumet Ave
Munster, IN 46321-2811
Phone (219) 836-1060

Other practice location 1

1500 S Lake Park Ave
Sp402
Hobart, IN 46342-6638
Phone (219) 945-4488

Other identifiers 2

IdentifierTypeStateIssuer
1336376367OtherNPI
201328430MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MUNSTER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006769 IN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 6406160423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2009
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)

10215 Broadway
Crown Point, IN 46307-8001

1500 S Lake Park Ave
Hobart, IN 46342-6638

1545 W US Hwy 30
Schererville, IN 46375-1562
Phone (219) 836-5381

3800 Saint Mary Rd
Valparaiso, IN 46383-3986

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4563

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement58
Lower limb (leg) arthroscopy (minimally invasive joint repair)26
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01075358BINMDOrthopaedic Surgery Physician
201328430INMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Sep 1, 2017 Accepting new patients
Munster Radiology Group PC Past Accepting new patients

Locations

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

1500 S Lake Park Ave
#402
Hobart, IN 46342
Phone (219) 945-4488

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

9445 Calumet Ave
Munster, IN 46321
Phone (219) 836-1060

1545 W US Highway 30
Schererville, IN 46375
Phone (219) 703-2440

3800 Saint Mary Rd
Ste 101
Valparaiso, IN 46383
Phone (219) 738-2081

Interoperability endpoints

  • Direct secure messaging: mknesek62713@ssdirect.comhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1336376367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9445 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212811",
            "telephone_number": "219-836-1060",
            "fax_number": "219-756-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9445 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212811",
            "telephone_number": "219-836-1060",
            "fax_number": "219-836-1014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Lake Park Ave",
            "address_2": "SP402",
            "address_purpose": "LOCATION",
            "city": "Hobart",
            "state": "IN",
            "postal_code": "463426638",
            "country_code": "US",
            "telephone_number": "219-945-4488",
            "fax_number": "219-947-6015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNESEK",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01075358B",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "201328430",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "201328430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1336376367",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201328430",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MUNSTER",
            "affiliation": "N",
            "address_1": "9445 Calumet Ave",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463212811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.