Individual provider Active NPI

Alexander Igolnikov, MD

  • Gastroenterology Physician
  • La Porte, IN
National Provider Identifier
1437249182
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01071639A Issued in IN
Practice address
901 Lincolnway
Suite 306
La Porte, IN 46350-3430
Phone
(219) 324-0875
Fax
(219) 324-0827
NPI assigned
Oct 13, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36108351 IL
Gastroenterology Physician 207RG0100X 01071639A IN Primary

Addresses

Primary practice location

901 Lincolnway
Suite 306
La Porte, IN 46350-3430

Mailing address

PO Box 1690
La Porte, IN 46352-1690
Phone (219) 326-2312

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Alexander.Igolnikov@laportehosp.cernerdirect.com

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
I20121110000067 IN Practitioner - Gastroenterology 4183622913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Southern Illinois University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Practice addresses (Care Compare)

104 E Culver Rd
Knox, IN 46534-2241

1331 State St
La Porte, IN 46350-3112

1509 State St
La Porte, IN 46350-3115
Phone (219) 326-5700

6923 W 400
Michigan City, IN 46360-9198
Phone (219) 325-0604

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy126
Upper gastrointestinal (GI) endoscopy for acid reflux150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36108351ILMDGastroenterology Physician
01071639AINMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Porte Clinic Company LLC CurrentSince Mar 1, 2016 Accepting new patients
La Porte Clinic Company LLC CurrentSince Mar 1, 2016 Accepting new patients
George N Atia, M.D., S.C. Gastroenterology Past Accepting new patients

Locations

104 E Culver Rd
Ste 102
Knox, IN 46534
Phone (574) 772-1580

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

402 W Culver Rd
Knox, IN 46534
Phone (219) 772-7918

1331 State St
Ste 240
La Porte, IN 46350
Phone (219) 326-0943

1331 State St
Ste 340
La Porte, IN 46350
Phone (219) 324-0875

7002 W Johnson Rd
La Porte, IN 46350
Phone (219) 325-0604

1007 Lincolnway
Laporte, IN 46350
Phone (219) 325-5474

1331 State St
Laporte, IN 46350
Phone (219) 326-2415

311 Boyd Blvd
Laporte, IN 46350
Phone (219) 326-2654

901 Lincolnway
Ste 306
Laporte, IN 46350
Phone (219) 324-0875

6923 W 400 N
Michigan City, IN 46360
Phone (219) 325-0604

Interoperability endpoints

  • Direct secure messaging: alexander.igolnikov@laportehosp.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437249182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463521690",
            "telephone_number": "219-326-2312",
            "fax_number": "219-326-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LINCOLNWAY",
            "address_2": "SUITE 306",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503430",
            "telephone_number": "219-324-0875",
            "fax_number": "219-324-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGOLNIKOV",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "36108351",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01071639A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Alexander.Igolnikov@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "901 Lincolnway",
            "address_2": "Suite 306",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463503430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.