Individual provider Active NPI

Jose D Mapalad, MD

  • Anesthesiology Physician
  • Hammond, IN
National Provider Identifier
1609863208
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01029364A Issued in IN
Practice address
5454 Hohman Ave
Hammond, IN 46320-1931
Phone
(219) 933-2270
Fax
(219) 852-2515
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01029364A IN Primary

Addresses

Primary practice location

5454 Hohman Ave
Hammond, IN 46320-1931

Mailing address

PO Box 1000
Dyer, IN 46311-0800
Phone (219) 864-2268

Other identifiers 1

IdentifierTypeStateIssuer
100259480MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01029364AINMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1609863208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-864-2268",
            "fax_number": "219-864-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201931",
            "telephone_number": "219-933-2270",
            "fax_number": "219-852-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAPALAD",
        "first_name": "JOSE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01029364A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259480",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.