Active NPI
Maura Rebecca Hantz, NP
- Family Nurse Practitioner
- Lagrange, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71014687A
- Practice address
- 2500 N Detroit St
Lagrange, IN 46761-1158 - Phone
- (260) 463-2133
- Fax
- (260) 463-3775
- NPI assigned
- Dec 12, 2023
- Last updated
- Dec 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71014687A | IN | Primary |
Addresses
Primary practice location
2500 N Detroit St
Lagrange, IN 46761-1158
Mailing address
PO Box 236
Lagrange, IN 46761-0236
Phone (260) 463-2133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 N Detroit St
Lagrange, IN 46761-1158
Phone (260) 463-2133
433 W High St
Bryan, OH 43506-1690
Phone 2604632133111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Internal Medicine Associates, PC | Current | Accepting new patients | |
| Northeast Internal Medicine Associates, PC | Past | Accepting new patients |
Locations
2500 N Detroit St
Lagrange, IN 46761
Phone (260) 463-2133
433 W High St
Bryan, OH 43506
Phone (419) 636-1131
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Lagrange, IN
- NPI 1174518500
OH
-
- Primary Care Nurse Practitioner
- Lagrange, IN
- NPI 1366859779
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Parkview Dekalb Hospital
- General Acute Care Hospital
- Auburn, IN
- NPI 1902897937
-
- General Acute Care Hospital
- Bryan, OH
- NPI 1962458521
-
dba Van Wert Health
- General Acute Care Hospital
- Van Wert, OH
- NPI 1942267760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1548038383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 236",
"city": "LAGRANGE",
"state": "IN",
"postal_code": "467610236",
"telephone_number": "260-463-2133",
"fax_number": "206-463-3775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N DETROIT ST",
"city": "LAGRANGE",
"state": "IN",
"postal_code": "467611158",
"telephone_number": "260-463-2133",
"fax_number": "260-463-3775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANTZ",
"first_name": "MAURA",
"middle_name": "REBECCA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-12",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71014687A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lagrange, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.