Internal Medicine,Geriatrics and Oncology Group, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01027933A Issued in IN

Legal business name

INTERNAL MEDICINE,GERIATRICS AND ONCOLOGY GROUP, P.C.

Practice address

2640 Hamstrom Rd
Portage, IN 46368-3832

Phone

(219) 762-9523

Fax

(219) 763-3120

NPI assigned

Jun 23, 2006

Last updated

Jul 18, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Diana G Neumann

Title

Billing Clerk

Phone

(219) 464-4786

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Shreyas A. Desai, M.D. Former legal business name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• Christina Connelly, FNP-C

  • Family Nurse Practitioner
  • Portage, IN
  • NPI 1750739702
  Medicare reassignment Care Compare group NPD
• Shreyas Arvind Desai, M.D.

  • Internal Medicine Physician
  • Portage, IN
  • NPI 1386646529
  Medicare reassignment Care Compare group NPD
• Ileana Green, FNP-C

  • Family Nurse Practitioner
  • Gary, IN
  • NPI 1477042505
  Medicare reassignment Care Compare group NPD
• Havishakrishna Sarma, DO

  • Internal Medicine Physician
  • Portage, IN
  • NPI 1992934020
  Medicare reassignment Care Compare group NPD
• Gayle Marie Voight-Block, FNP

  • Family Nurse Practitioner
  • Portage, IN
  • NPI 1861799090
  Medicare reassignment Care Compare group NPD
• Shaleena M Gates

  • Family Nurse Practitioner
  • Portage, IN
  • NPI 1700553906
  Medicare reassignment NPD
• Bobbi S Schwabe, NURSE PRACTITIONER

  • Nurse Practitioner
  • Dyer, IN
  • NPI 1962445932
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1417983537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 HAMSTROM RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683832",
            "telephone_number": "219-762-9523",
            "fax_number": "219-763-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HAMSTROM RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683832",
            "telephone_number": "219-762-9523",
            "fax_number": "219-763-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE,GERIATRICS AND ONCOLOGY GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "NEUMANN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "219-464-4786",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01027933A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100157480A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200201230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shreyas A. Desai, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Indiana Medical Ride Services LLC
• Lindsay E Ingersoll, OTR
• Inpatient Physician Group LLC (Ipg Nwi)
• Insights Counseling LLC
• Judith L Intagliata, SLP
• Zeenia Irani
• Alexis Lynette Izeta
• April Izeta
• J S Midmore MD PC (John Steven Midmore MD)
• Cody James Jackson, PHARMD

• Internal Medicine Physician in Portage, IN
• Providers in Portage, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.