Individual provider Active NPI

Michael Allan Streeter, D.O.

  • Emergency Medicine Physician
  • Crown Point, IN
National Provider Identifier
1629223318
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02003350A Issued in IN
Practice address
1201 S Main St
Crown Point, IN 46307-8481
Phone
(219) 757-6310
NPI assigned
Nov 21, 2008
Last updated
May 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02003350A IN Primary

Addresses

Primary practice location

1201 S Main St
Crown Point, IN 46307-8481

Mailing address

1040 Sierra Dr
Suite 400
Greenwood, IN 46143-7241
Phone (317) 528-4252

Other identifiers 2

IdentifierTypeStateIssuer
200926260MedicaidIN
000000722408OtherINANTHEM TRADITIONAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TN2 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
I20090422000478 IN Practitioner - Emergency Medicine 6800866997
I20200710003183 TN Practitioner - Emergency Medicine 6800866997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians

Practice addresses (Care Compare)

200 Stonecrest Blvd
Smyrna, TN 37167-6810
Phone (615) 768-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3983TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
St Anthony Medical Center Past Accepting new patients
Hospital Medicine Services of TN, LLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

107 Natchez Park Dr
Dickson, TN 37055
Phone (615) 326-2900

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

2300 Patterson St
#M
Nashville, TN 37203

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Organizations & group practices 3

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1629223318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-528-4252",
            "fax_number": "317-865-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-757-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETER",
        "first_name": "MICHAEL",
        "middle_name": "ALLAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02003350A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200926260",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRADITIONAL",
            "identifier": "000000722408",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.