Kovilparambil Xavier Antony – Psychiatry Physician

Key facts

NPI: 1376677138
Entity type: Individual (NPI type 1)
Primary specialty: Psychiatry Physician 2084P0800X
License: 01041392A (IN)
Practice address: 1100 W 6TH Avenue
Gary, IN 46402
Phone: (219) 885-4264
NPI assigned: Mar 15, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 5

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.

Evizzit of Iowa Psychiatry PC Psychiatry Physician · West Des Moines, IA · NPI 1740841188

Medicare reassignment NPD FL · IA · ND · PSYCHIATRY
Northeast Iowa Mental Health Center Mental Health Clinic/Center (Including Community Mental Health Center) · Decorah, IA · NPI 1710933445

Medicare reassignment NPD IA
Crossroads Behavioral Health Center Mental Health Clinic/Center (Including Community Mental Health Center) · Creston, IA · NPI 1053694802

NPD (past)
Evizzit of Iowa Psychiatry PC Adult Mental Health Clinic/Center · West Des Moines, IA · NPI 1679233183

NPD (past)
United Community Services, Inc. Point of Service · West Des Moines, IA · NPI 1609998137

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled (3 enrollments) in IA, FL, ND
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20140630001733	IA	Practitioner - Psychiatry	7113910266	Reassigns benefits to 2 organizations
I20140822001187	FL	Practitioner - Psychiatry Practitioner - Neurology	7113910266	Reassigns benefits to 1 organization
I20240304002509	ND	Practitioner - Psychiatry	7113910266	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
01041392A	IN	MD	Psychiatry Physician

Practice roles

Organization	Specialty	Status	New patients
Northeast Iowa Mental Health Center		Current since Jul 15, 2014	Accepting new patients
Evizzit of Iowa Psychiatry PC	Psychiatry	Current since Apr 1, 2020	Accepting new patients
Evizzit of Iowa Psychiatry PC		Past since Dec 26, 2021	Accepting new patients
Crossroads Behavioral Health Center		Past since Aug 3, 2025	Accepting new patients
United Community Services, Inc.		Past since Jul 15, 2014	Accepting new patients

Locations

905 Montgomery St
Decorah, IA 52101
Phone (563) 382-3649

1501 42nd St
Ste 575
West Des Moines, IA 50266
Phone 8552703625171

1501 42nd St
Ste 120
West Des Moines, IA 50266

Interoperability endpoints

Direct secure messaging: koilparambil.antony.1@31765.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychiatry Physician	2084P0800X	01041392A	IN	Yes

Addresses

Primary practice location

1100 W 6TH Avenue
Gary, IN 46402

Mailing address

12028 S Van Beveren Dr
Alsip, IL 60803-1700

Other providers in Gary, IN

All providers in Gary, IN · Psychiatry Physician in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.