Alexander Igolnikov, MD

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

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

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)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment Care Compare group NPD
• La Porte Clinic Company LLC

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD
• George N Atia, M.D., S.C.

  • Gastroenterology Physician
  • Barrington, IL
  • NPI 1730214271
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• La Porte Hospital Company LLC

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285
  Care Compare affiliation
• Porter Hospital LLC

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "151020007",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201096920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000782162",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108351",
            "state": "IL"
        }
    ],
    "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": []
}

• David B Hough, DO
• Carl Hufford, LCSW
• Misty Humes, RBT
• Margret Harpa Huntress, MA, LMHC
• Dina Mamdouh Hussein, DMD
• Indiana University Health la Porte Hospital Inc
• Indiana University Health la Porte Hospital Inc
• Indiana University Health la Porte Hospital Inc
• Indiana University Health la Porte Hospital Inc
• Indiana University Health la Porte Hospital Inc

• Gastroenterology Physician in La Porte, IN
• Providers in La Porte, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• 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.