NPIMap

Individual provider Active NPI

Matthew A R Libiran, MD

  • Family Medicine Physician
  • East Chicago, IN
National Provider Identifier
1588656995
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01059738A Issued in IN
Practice address
100 West Chicago Avenue
Suite F
East Chicago, IN 46312-3260
Phone
(219) 397-0193
Fax
(219) 397-0657
NPI assigned
Aug 22, 2005
Last updated
Nov 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01059738A IN Primary

Addresses

Primary practice location

100 West Chicago Avenue
Suite F
East Chicago, IN 46312-3260

Mailing address

100 West Chicago Avenue
Suite F
East Chicago, IN 46312-3260
Phone (219) 397-0193

Other identifiers 2

IdentifierTypeStateIssuer
01059738AOtherMEDICAL LICENSE
200531170MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000472 IN Practitioner - Family Practice 4082646658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
219 Health Network IncGroup PAC ID 0547521452, 70 clinicians
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

100 W Chicago Ave
Suite F
East Chicago, IN 46312-3261
Phone (219) 392-7016

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059738AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
219 Health Network Inc Family Medicine CurrentSince Feb 4, 2018 Accepting new patients
St Catherine Hospital Inc CurrentSince Jul 1, 2005 Accepting new patients
219 Health Network, Inc. CurrentSince Feb 4, 2018 Accepting new patients
St. Catherine Hospital Inc. CurrentSince Jul 1, 2005 Accepting new patients

Locations

100 W Chicago Ave
Ste F
East Chicago, IN 46312
Phone (219) 392-7016

4320 Fir St
Unit 210
East Chicago, IN 46312
Phone (219) 392-7670

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

4321 Fir St
Fl 4
East Chicago, IN 46312
Phone (219) 364-3811

6924 Indianapolis Blvd
Blvd
Hammond, IN 46324
Phone (219) 844-9060

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Powers HealthEast Chicago, IN, CCN 15T008 Hospital Corporate Director Jan 21, 2026

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1588656995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WEST CHICAGO AVENUE",
            "address_2": "SUITE F",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123260",
            "telephone_number": "219-397-0193",
            "fax_number": "219-397-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST CHICAGO AVENUE",
            "address_2": "SUITE F",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123260",
            "telephone_number": "219-397-0193",
            "fax_number": "219-397-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBIRAN",
        "first_name": "MATTHEW",
        "middle_name": "A R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01059738A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "01059738A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200531170",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.