Individual provider Active NPI

Samia Katherine Esseddiqi, CRNA

  • Certified Registered Nurse Anesthetist
  • Merrillville, IN
National Provider Identifier
1417325457
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28240074A Issued in IN
Practice address
8701 Broadway
Merrillville, IN 46410
Phone
(219) 738-5500
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28240074A IN Primary
Certified Registered Nurse Anesthetist 367500000X 2016003052 MO

Addresses

Primary practice location

8701 Broadway
Merrillville, IN 46410

Mailing address

204 McKinley St
Valparaiso, IN 46383-3549
Phone (425) 210-0057

Other practice location 1

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110-1003
Phone (314) 362-6973

Other practice location 2

600 Grant St
Gary, IN 46402-6001
Phone (219) 886-4000

Other practice location 3

101 E 87th Ave
Merrillville, IN 46410-7335
Phone (219) 738-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522001587 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981901469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter County Anesthesia Associates PCGroup PAC ID 4789573411, 29 clinicians

Practice addresses (Care Compare)

85 E US Hwy 6
Valparaiso, IN 46383-8947
Phone (219) 983-5743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2016003052MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Porter County Anesthesia Associates PC CurrentSince Jan 1, 2021 Accepting new patients

Locations

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1417325457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MCKINLEY ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833549",
            "telephone_number": "425-210-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-738-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "314-362-6973",
            "fax_number": "314-362-1185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Grant St",
            "address_purpose": "LOCATION",
            "city": "Gary",
            "state": "IN",
            "postal_code": "464026001",
            "country_code": "US",
            "telephone_number": "219-886-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E 87th Ave",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107335",
            "country_code": "US",
            "telephone_number": "219-738-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESSEDDIQI",
        "first_name": "SAMIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28240074A",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2016003052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.