Individual provider Active NPI

Patrick J Sheets, M.D.

  • Family Medicine Physician
  • Rensselaer, IN
National Provider Identifier
1396704268
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01054176 Issued in IN
Practice address
123 S McKinley Ave
Rensselaer, IN 47978-2949
Phone
(219) 866-1890
Fax
(219) 866-1871
NPI assigned
Mar 20, 2006
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01054176 IN Primary

Addresses

Primary practice location

123 S McKinley Ave
Rensselaer, IN 47978-2949

Mailing address

123 S McKinley Ave
Rensselaer, IN 47978-2949
Phone (219) 866-1890

Other practice location 1

565 S Countryside Lane
Monticello, IN 47960
Phone (574) 583-0353

Other identifiers 1

IdentifierTypeStateIssuer
200502790AMedicaidIN

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
I20040819001220 IN Practitioner - Family Practice 6608840327 Receives reassigned benefits from 2 practitioners
Practice locations: Rensselaer, IN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01054176INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Healthcare, LLC Family Medicine CurrentSince Mar 6, 2017 Accepting new patients
Jasper County Hospital PastSince Jan 1, 1990 Accepting new patients
Vein Associates of Northwest Indiana LLC Past Accepting new patients
Jasper County Hospital PastSince Jan 1, 1990 Accepting new patients
Jasper County Hospital PastSince Jan 1, 1990 Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

8550 Broadway
Merrillville, IN 46410
Phone (219) 736-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12167/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1396704268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S MCKINLEY AVE",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479782949",
            "telephone_number": "219-866-1890",
            "fax_number": "219-866-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S MCKINLEY AVE",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479782949",
            "telephone_number": "219-866-1890",
            "fax_number": "219-866-1871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 S Countryside Lane",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "IN",
            "postal_code": "47960",
            "country_code": "US",
            "telephone_number": "574-583-0353",
            "fax_number": "574-583-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEETS",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01054176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200502790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, IN

Sources for this page

Verify at the official NPI Registry.