Individual provider Active NPI

Abdulkader M Kulam, M.D.

  • Anesthesiology Physician
  • Merrillville, IN
National Provider Identifier
1629023791
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01056404A Issued in IN
Practice address
8701 Broadway
Merrillville, IN 46410-7035
Phone
(219) 738-5500
NPI assigned
May 24, 2006
Last updated
Apr 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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 01056404A IN Primary

Addresses

Primary practice location

8701 Broadway
Merrillville, IN 46410-7035

Mailing address

19627 S la Grange Rd
Mokena, IL 60448-9360
Phone (708) 326-1633

Other practice location 1

600 Grant St
Gary, IN 46402-6001
Phone (219) 886-4000

Other identifiers 2

IdentifierTypeStateIssuer
050090422OtherINRR MCARE
100440660MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071210000181 IN Practitioner - Anesthesiology 5597854836 Reassigns benefits to 2 organizations
I20091021000126 IL Practitioner - Anesthesiology 5597854836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Redreef Anesthesia Associates Chartered Indiana LLCGroup PAC ID 7012459647, 36 clinicians

Practice addresses (Care Compare)

4411 Washington Ave
Suite 100
Evansville, IN 47714-0805
Phone (313) 637-9861

600 Grant St
Gary, IN 46402-6001
Phone (888) 851-4642

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056404AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Redreef Anesthesia Associates Chartered Indiana LLC Anesthesiology CurrentSince Apr 25, 2024 Accepting new patients
Crawford Avenue Anesthesia Provider Services Urbana, LLC Anesthesiology Past Accepting new patients
Summit Anesthesia, LLC Anesthesiology Past Accepting new patients

Locations

11051 Broadway
Ste B
Crown Point, IN 46307
Phone (219) 308-0193

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

Organizations & group practices 5

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 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1629023791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19627 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489360",
            "telephone_number": "708-326-1633",
            "fax_number": "708-326-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107035",
            "telephone_number": "219-738-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Grant St",
            "address_purpose": "LOCATION",
            "city": "Gary",
            "state": "IN",
            "postal_code": "464026001",
            "country_code": "US",
            "telephone_number": "219-886-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULAM",
        "first_name": "ABDULKADER",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01056404A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "050090422",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100440660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.