NPIMap

Organization Active NPI

Orthopaedic Specialists of Northwest Indiana PC

  • Orthopaedic Surgery Physician
  • Munster, IN
National Provider Identifier
1497865794
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC SPECIALISTS OF NORTHWEST INDIANA PC
Practice address
9900 Columbia Ave
Munster, IN 46321-4008
Phone
(219) 924-3300
NPI assigned
Aug 30, 2006
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Martha Hackett
Title
Billing Lead
Phone
(219) 934-2652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

9900 Columbia Ave
Munster, IN 46321-4008

Mailing address

PO Box 3329
Munster, IN 46321-0329
Phone (219) 924-3300

Other practice location 1

10200 Wicker Ave Ste 1
Saint John, IN 46373-9439
Phone (219) 924-3300

Other practice location 2

730 45th Ave
Munster, IN 46321
Phone (219) 924-3300

Other identifiers 4

IdentifierTypeStateIssuer
000000104771OtherINANTHEM GROUP
129555400OtherUS DEPT LABOR
200135850AMedicaidIN
90000692OtherBCIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdedhia@OSNWI1911.srs-direct.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040818000914 IN Part B Supplier - Clinic/Group Practice 5092788901 Receives reassigned benefits from 23 practitioners
Practice locations: Munster, IN; Saint John, IN

National Provider Directory

National Provider Directory

Locations

10200 Wicker Ave
Ste St
Saint John, IN 46373

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1497865794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3329",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463210329",
            "telephone_number": "219-924-3300",
            "fax_number": "219-934-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214008",
            "telephone_number": "219-924-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10200 Wicker Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Saint John",
            "state": "IN",
            "postal_code": "463739439",
            "country_code": "US",
            "telephone_number": "219-924-3300",
            "fax_number": "219-922-5424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 45th Ave",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "46321",
            "country_code": "US",
            "telephone_number": "219-924-3300",
            "fax_number": "219-934-2658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPAEDIC SPECIALISTS OF NORTHWEST INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "HACKETT",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "BILLING LEAD",
        "authorized_official_telephone_number": "219-934-2652"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP",
            "identifier": "000000104771",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT LABOR",
            "identifier": "129555400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200135850A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCIL",
            "identifier": "90000692",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdedhia@OSNWI1911.srs-direct.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "730 45th Ave",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.