Mary P Kustron

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71008629A Issued in IN

Practice address

320 W 61St Ave
Hobart, IN 46342-6490

Phone

(219) 947-6448

Fax

(219) 947-6839

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians

Midwest Express Care, IncGroup PAC ID 5193957595, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.kustron.p1@direct.northshorehealth.nextgenshare.com

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.

• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Hammond, IN
  • NPI 1629502810
  Medicare reassignment Care Compare group
• Midwest Express Care, Inc

  • Urgent Care Clinic/Center
  • Schererville, IN
  • NPI 1942642848
  Medicare reassignment Care Compare group
• Northshore Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300
  Medicare reassignment NPD
• Nwi Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Munster, IN
  • NPI 1043596703
  Medicare reassignment NPD
• Hansa Medical Groupe PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1386804615

  IN

  Medicare reassignment NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Schererville, IN
  • NPI 1255006862
  NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  NPD (past)
• Uro Surgery Associates LLC

  • Urology Physician
  • Merrillville, IN
  • NPI 1477648566
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1720568017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W 61ST AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426490",
            "telephone_number": "219-947-6448",
            "fax_number": "219-947-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 61ST AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426490",
            "telephone_number": "219-947-6448",
            "fax_number": "219-947-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTRON",
        "first_name": "MARY",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28150133A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008629A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodora Koktsidis, HEALTH ADMINISTRATOR
• Lindsey Marie Kolakoski, PMHNP-BC
• Koppolu P Sarma MD Inc
• Christina M Korem, FNP-C
• Maureen Kozlow, PA-C
• Fadee Kutom, MD
• Labcorp Indiana Inc
• Laboratory Corporation of America Holdings
• Lake Park Clinic, P.C.
• Lake Park Dental Group

• Family Nurse Practitioner in Hobart, IN
• Providers in Hobart, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.