Individual provider Active NPI

Marion A. Trybula, M.D.

  • Hematology & Oncology Physician
  • Merrillville, IN
National Provider Identifier
1396722328
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
01045710 Issued in IN
Practice address
200 E 89TH Ave
Suite 2a
Merrillville, IN 46410-7319
Phone
(219) 736-2800
Fax
(219) 736-6680
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 01045710 IN Primary

Addresses

Primary practice location

200 E 89TH Ave
Suite 2a
Merrillville, IN 46410-7319

Mailing address

200 E 89TH Ave
Suite 2a
Merrillville, IN 46410-7319
Phone (219) 736-2800

Other identifiers 10

IdentifierTypeStateIssuer
000000085042OtherUNICARE
238805OtherHARMONY HEALTH
830003898OtherTRAVELERS MEDICARE
9210030OtherADVOCATE PHO
200101980AOtherMOLINA
91115213OtherILBLUE CROSS/BLUE SHIELD
000000085042OtherINDIANA CARPENTERS
200101980MedicaidIN
000000085042OtherINANTHEM
238805OtherWELLCARE

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
I20100721000765 IN Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5193629335 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suniti Medical Corporation CurrentSince Jun 1, 2010 Accepting new patients
Suniti Medical Corporation CurrentSince Jun 1, 2010 Accepting new patients

Locations

200 E 89th Ave
Ste 2A
Merrillville, IN 46410
Phone (219) 736-2800

929 Ridge Rd
Ste 5
Munster, IN 46321
Phone (219) 836-2000

Interoperability endpoints

  • Direct secure messaging: marion.trybula@poha.direct-geniusdoc.com
  • Direct secure messaging: marion.trybula@pomh.direct-geniusdoc.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1396722328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 89TH AVE",
            "address_2": "SUITE 2A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107319",
            "telephone_number": "219-736-2800",
            "fax_number": "219-736-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 89TH AVE",
            "address_2": "SUITE 2A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107319",
            "telephone_number": "219-736-2800",
            "fax_number": "219-736-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYBULA",
        "first_name": "MARION",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01045710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "000000085042",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY HEALTH",
            "identifier": "238805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "830003898",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE PHO",
            "identifier": "9210030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "200101980A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "91115213",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA CARPENTERS",
            "identifier": "000000085042",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200101980",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000085042",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "238805",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.