Neil William Wangstrom, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01038858 Issued in IN

Practice address

304 Detroit St
La Porte, IN 46350-2497

Phone

(219) 325-3770

Fax

(219) 325-8181

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Washington University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
• Northwest Health - Starke Hospital, Knox, IN, CCN 150102
• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035
• Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

Merit-based Incentive Payment System (MIPS)

Final score

90.68 of 100Reported as apm

Quality

76.2

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: neil.wangstrom@laportehosp.cernerdirect.com

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.

• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment Care Compare group NPD
• Chesterton Physical Therapy, Inc.

  • Physical Therapist
  • Chesterton, IN
  • NPI 1467608687
  Care Compare group
• La Porte Clinic Company LLC

  dba La Porte Physician Network Ophthalmology Care

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD
• Neil Wangstrom MD PC

  • Otolaryngology Physician
  • La Porte, IN
  • NPI 1043307978
  NPD

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

• Franciscan Health Michigan City

  dba Franciscan Health Michigan City at La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1679336747
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • Michigan City, IN
  • NPI 1710051941
  Care Compare affiliation
• Knox Hospital Company LLC

  dba Northwest Health- Starke

  • Rural Acute Care Hospital
  • Knox, IN
  • NPI 1679948319
  Care Compare affiliation
• La Porte Hospital Company LLC

  dba Northwest Health-La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285
  Care Compare affiliation
• Porter Hospital LLC

  dba Northwest Health-Porter

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1730189820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463521690",
            "telephone_number": "219-326-2312",
            "fax_number": "219-326-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 DETROIT ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502497",
            "telephone_number": "219-325-3770",
            "fax_number": "219-325-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGSTROM",
        "first_name": "NEIL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01038858",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IN",
            "license": "01038858",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IN",
            "license": "01038858",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "IN",
            "license": "01038858",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "IN",
            "license": "01038858",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IN",
            "license": "01038858",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M400041676",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000697664",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165330",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NEIL.WANGSTROM@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "304 Detroit St",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463502497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Otolaryngology Physician in La Porte, IN
• Providers in La Porte, IN by specialty
• Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.