Individual provider Active NPI

Teressa M Meseberg

  • Family Nurse Practitioner
  • Munster, IN
National Provider Identifier
1710411228
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007035A Issued in IN
Practice address
801 Main St
Munster, IN 46321-4066
Phone
(219) 924-2491
NPI assigned
Apr 12, 2017
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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 71007035A IN Primary

Addresses

Primary practice location

801 Main St
Munster, IN 46321-4066

Mailing address

10247 Towle St
Dyer, IN 46311-0029
Phone (219) 789-6603

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
I20170504002062 IN Practitioner - Nurse Practitioner 9032496872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostics of Indiana LLCGroup PAC ID 3072548502, 121 clinicians

Practice addresses (Care Compare)

310 N Halleck St
Demotte, IN 46310-9419
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostics of Indiana, LLC Family CurrentSince Apr 21, 2017 Accepting new patients

Locations

310 N Halleck St
Demotte, IN 46310
Phone (219) 987-3301

9805 Geist Crossing Dr
Indianapolis, IN 46256
Phone (317) 577-1353

801 Main St
Munster, IN 46321
Phone (219) 924-2491

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1710411228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10247 TOWLE ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110029",
            "telephone_number": "219-789-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MAIN ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214066",
            "telephone_number": "219-924-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESEBERG",
        "first_name": "TERESSA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007035A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.