Organization Active NPI

Northwest Endocrinology & Diabetes PC

  • Specialist
  • Merrillville, IN
National Provider Identifier
1730343328
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01045632B Issued in IN
Legal business name
NORTHWEST ENDOCRINOLOGY & DIABETES PC
Practice address
270 E 90TH Dr Ste B
Merrillville, IN 46410-8102
Phone
(219) 736-1758
Fax
(219) 736-1717
NPI assigned
Jul 14, 2008
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Nihad Muhrez, M.D.NPI 1528098506
Title
Physician/Owner
Phone
(219) 736-1758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01045632B IN Primary

Addresses

Primary practice location

270 E 90TH Dr Ste B
Merrillville, IN 46410-8102

Mailing address

270 E 90TH Dr Ste B
Merrillville, IN 46410-8102
Phone (219) 736-1758

Other identifiers 2

IdentifierTypeStateIssuer
201042540MedicaidIN
000000219451OtherINANTHEM BLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090102000007 IN Part B Supplier - Clinic/Group Practice 4284796152 Receives reassigned benefits from 1 practitioner
Practice locations: Merrillville, IN

National Provider Directory

National Provider Directory

Locations

270 E 90th Dr
Ste B
Merrillville, IN 46410
Phone (219) 736-1758

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1730343328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E 90TH DR STE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108102",
            "telephone_number": "219-736-1758",
            "fax_number": "219-736-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E 90TH DR STE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108102",
            "telephone_number": "219-736-1758",
            "fax_number": "219-736-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ENDOCRINOLOGY & DIABETES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MUHREZ",
        "authorized_official_first_name": "NIHAD",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "219-736-1758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01045632B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201042540",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "000000219451",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.