Maximo V. Bleza, D.O.
Individual provider Active NPI Diagnostic Radiology Physician · Valparaiso, IN
NPI 1619924461 · NPPES record last updated Nov 13, 2007
Key facts
- NPI
- 1619924461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 02002230A (IN)
- Practice address
- 825 E Lincolnway
Valparaiso, IN 46383-5803 - Phone
- (219) 464-4891
- Fax
- (219) 464-1873
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Radiologic Associates of Northwest Indiana PC
Lutheran HBP Services LLC
Pulaski Memorial Hospital
Practice addresses (Care Compare)
1900 Roosevelt Rd
Valparaiso, IN 46383-2780
Phone (219) 263-4923
265 Turnberry Dr
Valparaiso, IN 46385-9273
Phone (219) 983-8300
3630 Willowcreek Rd
Portage, IN 46368-5075
Phone (219) 364-3000
616 E 13TH St
Winamac, IN 46996-1117
Phone (574) 946-2100
85 E US Hwy 6
Valparaiso, IN 46383-8947
Phone (219) 983-8300
9301 Connecticut Dr
Crown Point, IN 46307-7486
Phone (219) 756-2100
Hospital & facility affiliations
- Northwest Health - Porter
- Pulaski Memorial Hospital
- Northwest Health-la Porte
- St Mary Medical Center Inc
- Northwest Health - Starke
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040202000179 | IN | Practitioner - Diagnostic Radiology | 4284537655 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02002230A | IN | MD | Nuclear Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulaski Memorial Hospital | Current | Accepting new patients | |
| Indiana Regional P E T and Imaging Center, LLC | Current |
Accepting new patients | |
| Lutheran HBP Services, LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Radiologic Associates of Northwest Indiana, PC | Diagnostic Radiology | Current |
Accepting new patients |
| Pulaski Memorial Hospital | Current | Accepting new patients | |
| Pulaski Memorial Hospital | Current |
Accepting new patients | |
| Pulaski Memorial Hospital | Current |
Accepting new patients | |
| Southlake MRI & Diagnostic Center LLC | Current |
Accepting new patients | |
| Medical Group Surgery Center LLC | Past | Accepting new patients | |
| Dunes Optical, LLC | Past | Accepting new patients |
Locations
9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100
7891 Broadway
Ste A
Merrillville, IN 46410
Phone (219) 756-3988
108 E 90th Dr
Merrillville, IN 46410
Phone (219) 795-1801
85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743
825 Lincolnway
Valparaiso, IN 46383
Phone (219) 464-4891
616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100
540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Radiology Physician | 2085N0904X | 02002230A | IN | |
| Diagnostic Radiology Physician | 2085R0202X | 02002230A | IN | Yes |
Addresses
Primary practice location
825 E Lincolnway
Valparaiso, IN 46383-5803
Mailing address
825 E Lincolnway
Valparaiso, IN 46383-5803
Phone (219) 464-4891
Other providers in Valparaiso, IN
- Nicolette Bizoukas
- Elaina Robin Black
- Stanley Neil Blackman
- Amanda Gale Blade
- Lauren Elizabeth Blasko
- Block & Stevenson Oms PC
- Bloom Counseling LLC
- Kenneth Wayne Blumenthal
- Courtney Bobier
- Kevin Lee Boblitt
All providers in Valparaiso, IN · Diagnostic Radiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.