NPIMap

Organization Active NPI

Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
National Provider Identifier
1689627598
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
418-0-CMHC Issued in IN
Legal business name
PORTER-STARKE SERVICES INC.
Practice address
2507 Cumberland Dr
Valparaiso, IN 46383-2503
Phone
(219) 476-4676
Fax
(219) 462-3975
NPI assigned
May 19, 2006
Last updated
Jun 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Mrs. Mary K. Idstein, CPA
Title
Executive Vice President, Finance
Phone
(219) 531-3500

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 418-0-ASR IN
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 418-0-GAM IN
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 418-0-SMI IN
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 418-14-9-14 IN
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 418-0-CMHC IN Primary
Methadone Clinic 261QM2800X 61100664B IN

Addresses

Primary practice location

2507 Cumberland Dr
Valparaiso, IN 46383-2503

Mailing address

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 531-3500

Other identifiers 3

IdentifierTypeStateIssuer
000000112682OtherINANTHEM
CB7125OtherINMEDICARE RAILROAD
100207670AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040330000098 IN Part B Supplier - Clinic/Group Practice 1951293554 Receives reassigned benefits from 108 practitioners
6 other NPIs on this enrollment
Practice locations: Valparaiso, IN; Portage, IN; Knox, IN; Gary, IN; Hebron, IN
O20191204002063 IN Part B Supplier - Opioid Treatment Program (Otp) 1951293554 Practice locations: La Porte, IN; Valparaiso, IN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1003 S Edgewood Dr
Knox, IN 46534
Phone (574) 722-4040

3176 Lancer St
Portage, IN 46368
Phone (219) 762-7318

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Porter Starke Services IncValparaiso, IN, CCN 154052 Hospital Operational/Managerial Control
Other		 Jul 24, 1967
Jul 24, 1967
Marram Health CenterGary, IN, CCN 151956 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 27, 2015
Marram Health CenterHebron, IN, CCN 151051 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 24, 1967

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1689627598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500",
            "fax_number": "219-462-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 CUMBERLAND DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832503",
            "telephone_number": "219-476-4676",
            "fax_number": "219-462-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER-STARKE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "IDSTEIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "219-531-3500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "418-0-ASR",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "418-0-GAM",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "418-0-SMI",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "418-14-9-14",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "418-0-CMHC",
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "IN",
            "license": "61100664B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000112682",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB7125",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100207670A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.