Organization Active NPI

Northwest Indiana Id Associates PC

  • Infectious Disease Physician
  • Highland, IN
National Provider Identifier
1659742385
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01062044 Issued in IN
Legal business name
NORTHWEST INDIANA ID ASSOCIATES PC
Practice address
9696 Gordon Dr
Highland, IN 46322-2909
Phone
(219) 937-2511
Fax
(219) 937-2522
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Dr. Kinan Attassi, MDNPI 1255428157
Title
Owner
Phone
(630) 923-3555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01062044 IN Primary

Addresses

Primary practice location

9696 Gordon Dr
Highland, IN 46322-2909

Mailing address

9696 Gordon Dr
Highland, IN 46322-2909
Phone (219) 937-2511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151028000759 IN Part B Supplier - Clinic/Group Practice 6608185988 Receives reassigned benefits from 1 practitioner
Practice locations: Highland, IN; Munster, IN

National Provider Directory

National Provider Directory

Locations

9696 Gordon Dr
Highland, IN 46322
Phone (219) 937-2511

740 Seberger Dr
Munster, IN 46321
Phone (219) 237-6474

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1659742385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9696 GORDON DR",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222909",
            "telephone_number": "219-937-2511",
            "fax_number": "219-937-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9696 GORDON DR",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222909",
            "telephone_number": "219-937-2511",
            "fax_number": "219-937-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA ID ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "ATTASSI",
        "authorized_official_first_name": "KINAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-923-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01062044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.