NPIMap

Organization Active NPI

Porter-Starke Services Inc

  • Psychiatric Hospital
  • Valparaiso, IN
National Provider Identifier
1497807572
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PORTER-STARKE SERVICES INC
Practice address
701 Wall St
Valparaiso, IN 46383-2514
Phone
(219) 531-3500
Fax
(219) 462-3975
NPI assigned
Jan 17, 2007
Last updated
Sep 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Mary K. Idstein, C.P.A
Title
Executive Vice President
Phone
(219) 531-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X IN Primary

Addresses

Primary practice location

701 Wall St
Valparaiso, IN 46383-2514

Mailing address

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 531-3500

Other identifiers 1

IdentifierTypeStateIssuer
200871590AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070129000323 IN Part A Provider - Hospital 1951293554 Practice locations: Knox, IN; Portage, IN; Valparaiso, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497807572. Details of each certification follow.

Hospital certification: CCN 154052

Legal name
PORTER-STARKE SERVICES INC
Doing business as
PORTER STARKE SERVICES INC
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Aug 1, 2007
Last certification
Oct 19, 2022
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
701 Wall St
Valparaiso, IN 46383-2514
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Porter-Starke Services IncCCN 154052 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Porter Starke Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Clarence Boykin Individual Corporate OfficerVP, Marram Health Centers Jan 16, 2018
W-2 Managing EmployeeVP, Marram Health Centers Jan 16, 2018
Andrew Nielsen Individual Corporate OfficerCfo Jan 16, 2018
W-2 Managing EmployeeCfo Jan 16, 2018
Porter-Starke Services Inc Organization, Valparaiso, IN Non-profit Operational/Managerial Control Jul 24, 1967
Other Jul 24, 1967
Lisa Scheller Individual Corporate DirectorBoard Member Mar 24, 2026
Vanessa Allen-McCloud Individual Corporate DirectorBoard Member Jan 29, 2025
Mary Elizabeth Kominiak Individual Corporate DirectorBoard Member Jan 29, 2025
Robert Bryant Individual Corporate DirectorBoard Member Jan 29, 2025
Otto Shragal Individual Corporate DirectorBoard Member Mar 24, 2026
Andrew Zromkoski Individual Corporate DirectorBoard Member Jan 29, 2025
Mark Goodrich Individual Corporate OfficerVP, Human Resources Jan 16, 2018
W-2 Managing EmployeeVP, Human Resources Jan 16, 2018
Kate Sanders Individual Corporate OfficerVP, Systems Administration Jan 16, 2018
W-2 Managing EmployeeVP, Systems Administration Jan 16, 2018
Chad Nally Individual Corporate DirectorBoard Member Jan 29, 2025
Sharron Liggins Individual Corporate DirectorBoard Member Jan 29, 2025
Judith Jelinek Individual Corporate DirectorBoard Member Jan 29, 2025
Sandra Ruth Carlson Individual Corporate OfficerVP, Clinical Services Jan 16, 2018
W-2 Managing EmployeeVP, Clinical Services Jan 16, 2018
Susan Kelly-Johnson Individual Corporate DirectorBoard Member Jan 29, 2025
Irene Szakonyi Individual Corporate DirectorBoard Member Sep 2, 2025
Michael Weaver Individual Corporate OfficerVP, Medical Services Jan 16, 2018
W-2 Managing EmployeeVP, Medical Services Jan 16, 2018
Matthew Burden Individual Corporate OfficerCeo Jan 16, 2018
W-2 Managing EmployeeCeo Jan 16, 2018
Operational/Managerial ControlCeo Jan 16, 2018

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marram Health CenterGary, IN, CCN 151956 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 27, 2015
Marram Health CenterHebron, IN, CCN 151051 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 24, 1967

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1497807572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832514",
            "telephone_number": "219-531-3500",
            "fax_number": "219-462-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER-STARKE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "IDSTEIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "219-531-3500",
        "authorized_official_credential": "C.P.A"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200871590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.