Individual provider Active NPI

Anthony Victor Piasecki, PA-C

  • Physician Assistant
  • Hobart, IN
National Provider Identifier
1679300073
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004621A Issued in IN
Practice address
1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone
(219) 942-0551
NPI assigned
Sep 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10004621A IN Primary

Addresses

Primary practice location

1500 S Lake Park Ave
Hobart, IN 46342-6638

Mailing address

3612 E Engel Dr
Valparaiso, IN 46383-8339

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
I20241211003756 IN Practitioner - Physician Assistant 1153857370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

7651 Harvest Dr
Schererville, IN 46375-3476
Phone (219) 322-5723

9130 Columbia Ave
Munster, IN 46321-2932

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Dec 1, 2024 Accepting new patients
Cep America LLC CurrentSince Dec 1, 2024 Accepting new patients
Community Care Network Inc Physician Assistant CurrentSince May 1, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

10240 Calumet Ave
Munster, IN 46321
Phone (219) 440-5286

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

7651 Harvest Dr
Schererville, IN 46375
Phone (219) 322-5723

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1679300073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 E ENGEL DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S LAKE PARK AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426638",
            "telephone_number": "219-942-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIASECKI",
        "first_name": "ANTHONY",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004621A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

Verify at the official NPI Registry.