Individual provider Active NPI

Breanne Kowalski, FNP-C

  • Family Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1669063814
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01211249 Issued in IN
Practice address
5043 E 81St Ave
Merrillville, IN 46410-5912
Phone
(219) 707-5276
NPI assigned
Jan 31, 2021
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01211249 IN Primary

Addresses

Primary practice location

5043 E 81St Ave
Merrillville, IN 46410-5912

Mailing address

5043 E 81St Ave
Merrillville, IN 46410-5912
Phone (219) 707-5276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603002029 IN Practitioner - Nurse Practitioner 5799184271 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians
Nwi Urgent Care, LLCGroup PAC ID 7618142977, 45 clinicians

Practice addresses (Care Compare)

129 E 107TH Ave
Crown Point, IN 46307-6517
Phone (219) 662-4134

31 E Sibley St
Suite a
Hammond, IN 46320-1725
Phone (219) 802-8800

5521 W Lincoln Hwy
Suite 1a
Crown Point, IN 46307-1098
Phone (219) 769-1362

8135 Calumet Ave
Munster, IN 46321-1701
Phone (219) 513-2000

875 Joliet St
Dyer, IN 46311-1920
Phone (219) 440-7340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F01211249INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Urgent Care, LLC CurrentSince Jun 15, 2021 Accepting new patients
Aims, LLC CurrentSince Apr 1, 2021 Accepting new patients
Aims-Med, LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

9330 Broadway
Crown Point, IN 46307
Phone (219) 648-2400

111 E 3rd St
Unit 764
Mishawaka, IN 46546

1625 E Jefferson Blvd
Mishawaka, IN 46545
Phone (219) 257-2295

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

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": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1669063814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5043 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105912",
            "telephone_number": "219-707-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105912",
            "telephone_number": "219-707-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "BREANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F01211249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.