Lee M Periolat, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01026484 Issued in IN

Practice address

601 Wall St
Valparaiso, IN 46383-2512

Phone

(219) 531-3662

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment NPD
• Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1659196236
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1417974072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIOLAT",
        "first_name": "LEE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01026484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lperiolat@porterstarke.direct.smartcarenet.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 Wall St",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463832512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Pena
• Ruth J Pera, P.T.
• Ashley Lynne Peres, MSW, LCSW
• Valerie Perez, PSYD/ HSPP
• Melanie A Pergiel, ANP
• Laura L Perlstein, PT
• Noel Perry
• Dustin Michael Person
• Personal Health Management, PC
• Sarah Pessmeg Rossi, LMHC

• Psychiatry Physician in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.