Individual provider Active NPI

Tiffany Nicole Berber-Stanisz, FNP

  • Nurse Practitioner
  • Munster, IN
National Provider Identifier
1730603937
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71007428A Issued in IN
Practice address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone
(219) 836-1600
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 28162734A IN
Family Nurse Practitioner 363LF0000X 71007428A IN
Nurse Practitioner 363L00000X 71007428A IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2901

Mailing address

6602 W 127TH PL
Cedar Lake, IN 46303-7124
Phone (219) 484-8941

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
I20170929000994 IN Practitioner - Nurse Practitioner 8527333673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

9660 Wicker Ave
Saint John, IN 46373-9487
Phone (219) 365-1166

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28162734AINMDGeneral Practice Registered Nurse
71007428AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Nurse Practitioner CurrentSince Dec 3, 2017 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

Interoperability endpoints

  • Direct secure messaging: tberber8170@ssdirect.comhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1730603937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 W 127TH PL",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463037124",
            "telephone_number": "219-484-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBER-STANISZ",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28162734A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007428A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007428A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.