Organization Active NPI

Urologic Surgery of Nwi, PC

  • Non-Pharmacy Dispensing Site
  • Valparaiso, IN
National Provider Identifier
1770448607
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
UROLOGIC SURGERY OF NWI, PC
Practice address
1101 Glendale Blvd Ste 107a
Valparaiso, IN 46383-3775
Phone
(917) 693-6363
Fax
(219) 286-6909
NPI assigned
Dec 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Genri Pinkhasov, MDNPI 1639370893
Title
President
Phone
(917) 693-6363

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
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1101 Glendale Blvd Ste 107a
Valparaiso, IN 46383-3775

Mailing address

1101 Glendale Blvd Ste 107a
Valparaiso, IN 46383-3775
Phone (917) 693-6363

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2319148Urologic Surgery of Nwi, PC1101 Glendale Blvd Unit 107a, Valparaiso, IN 46383Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Urologic Surgery of Nwi2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1770448607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 GLENDALE BLVD STE 107A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833775",
            "telephone_number": "917-693-6363",
            "fax_number": "219-286-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GLENDALE BLVD STE 107A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833775",
            "telephone_number": "917-693-6363",
            "fax_number": "219-286-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGIC SURGERY OF NWI, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "PINKHASOV",
        "authorized_official_first_name": "GENRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-693-6363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.