NPIMap

Organization Active NPI

Northwest Indiana Pathology Consultants PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Munster, IN
National Provider Identifier
1669459632
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
NORTHWEST INDIANA PATHOLOGY CONSULTANTS PC
Practice address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone
(800) 288-8325
Fax
(419) 866-5453
NPI assigned
Dec 29, 2005
Last updated
Jan 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Authorized official

Name
Heidi Nordbrock, MDNPI 1700871514
Title
M.D. President
Phone
(219) 836-1600

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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2901

Mailing address

PO Box 10805
Merrillville, IN 46410-0805
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
200404920MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000016 IN Part B Supplier - Clinic/Group Practice 0446243943 Receives reassigned benefits from 13 practitioners
Practice locations: East Chicago, IN; Hobart, IN; Munster, IN

National Provider Directory

National Provider Directory

Locations

7750 Solution Ctr
Chicago, IL 60677

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1669459632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10805",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464100805",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA PATHOLOGY CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "NORDBROCK",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "M.D. PRESIDENT",
        "authorized_official_telephone_number": "219-836-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200404920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.