NPIMap

Organization Active NPI

St. Mary Medical Center Inc

Doing business as Michael Kovacich MD

  • Family Medicine Physician
  • Merrillville, IN
National Provider Identifier
1598839730
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. MARY MEDICAL CENTER INC
Doing business as
Michael Kovacich MD
Practice address
200 E 80TH Place
Ste 100
Merrillville, IN 46410-5671
Phone
(219) 769-7536
Fax
(219) 736-1506
NPI assigned
Nov 20, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. MARY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Janice Ryba
Title
Ceo
Phone
(219) 942-0551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

200 E 80TH Place
Ste 100
Merrillville, IN 46410-5671

Mailing address

9660 Wicker Avenue
St John, IN 46373-9487
Phone (219) 226-2203

Other names 1

  • Michael Kovacich MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000490 IN Part B Supplier - Clinic/Group Practice 2365424348 Receives reassigned benefits from 3 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hobart, IN

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
St Mary Medical Center in

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1598839730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9660 WICKER AVENUE",
            "city": "ST JOHN",
            "state": "IN",
            "postal_code": "463739487",
            "telephone_number": "219-226-2203",
            "fax_number": "219-226-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 80TH PLACE",
            "address_2": "STE 100",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105671",
            "telephone_number": "219-769-7536",
            "fax_number": "219-736-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY MEDICAL CENTER INC",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "RYBA",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-942-0551"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Kovacich MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.