Medina Healthcare SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036089606 Issued in IL

Legal business name

MEDINA HEALTHCARE SC

Practice address

932 Richard Rd
Dyer, IN 46311-1936

Phone

(219) 515-2148

NPI assigned

Jun 18, 2010

Organization subpart

No

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

Authorized official

Name

Katie A Werner

Title

Credentialing

Phone

(630) 261-9286

Specialties & licenses 1

Addresses

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Huma Tazeem Mulk, M.D.

  • Internal Medicine Physician
  • Dyer, IN
  • NPI 1497884027
  Medicare reassignment
• Syed Affan Ul Haq Hashmi, MD

  • Nephrology Physician
  • Olympia Fields, IL
  • NPI 1164787792
  NPD
• Mustafa Hunaid Kagalwalla, MD

  • Nephrology Physician
  • Olympia Fields, IL
  • NPI 1093190076
  NPD

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1487975900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "708-982-1544",
            "fax_number": "219-440-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "219-515-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA HEALTHCARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "630-261-9286"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036089606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope McGee
• Megan Rose McKenzie, MS, LAT, ATC
• Alexis Mary McMahon, SPEECH PATHOLOGIST
• Victoria Louise McMahon, FNP-C
• Medical Specialists Inc., PC
• Jasmine Sky Mercado
• Jacqueline Nicole Mergenthaler
• Matthew E Meyer, MD
• Amanda Meyers, NP-C
• Aurelia Mican, M.D.

• Internal Medicine Physician in Dyer, IN
• Providers in Dyer, 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 Dec 5, 2023; 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.