Individual provider Active NPI

Sajiv John, M.D.

  • Addiction Psychiatry Physician
  • Valparaiso, IN
National Provider Identifier
1457348591
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
01045604A Issued in IN
Practice address
601 Wall St
Valparaiso, IN 46383-2512
Phone
(219) 531-3500
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 01045604A IN
Psychiatry Physician 2084P0800X 01045604A IN
Addiction Psychiatry Physician 2084P0802X 01045604A IN Primary

Addresses

Primary practice location

601 Wall St
Valparaiso, IN 46383-2512

Mailing address

1131 Turnberry Dr
Schererville, IN 46375-2935
Phone (219) 322-8936

Other identifiers 1

IdentifierTypeStateIssuer
200290140AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjohn@porterstarke.direct.smartcarenet.com Direct

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
I20120328000085 IN Practitioner - Psychiatry 4789844895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter-Starke Services IncGroup PAC ID 1951293554, 44 clinicians

Practice addresses (Care Compare)

601 Wall St
Valparaiso, IN 46383-2512
Phone (574) 772-4040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045604AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince Oct 2, 2000 Accepting new patients
Porter-Starke Services Inc. CurrentSince Oct 2, 2000 Accepting new patients

Locations

1001 S Edgewood Dr
Ste 1
Knox, IN 46534
Phone (574) 772-4040

3176 Lancer St
Portage, IN 46368
Phone (219) 762-7318

701 Wall St
Valparaiso, IN 46383
Phone (219) 299-8419

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1457348591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 TURNBERRY DR",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463752935",
            "telephone_number": "219-322-8936"
        },
        {
            "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": "219-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SAJIV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "IN",
            "license": "01045604A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01045604A",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "IN",
            "license": "01045604A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290140A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohn@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": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.