Individual provider Active NPI

Angelique D Brown, M.D.

  • Family Medicine Physician
  • Merrillville, IN
National Provider Identifier
1770553166
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01045570A Issued in IN
Practice address
6111 Harrison St
Suite 331
Merrillville, IN 46410-2969
Phone
(219) 887-1340
Fax
(219) 887-1518
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01045570A IN Primary

Addresses

Primary practice location

6111 Harrison St
Suite 331
Merrillville, IN 46410-2969

Mailing address

8777 Broadway
Suite 331
Merrillville, IN 46410-6693
Phone (219) 738-3854

Other identifiers 5

IdentifierTypeStateIssuer
207Q0000XOtherINTAXONOMY CODE
15D0938335OtherINCLIA #
01045570AOtherINPHYSICIAN'S LICENSE #
200098750BMedicaidIN
01045570BOtherINCONTROLLED SUBSTANCE #

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000704 IN Practitioner - Family Practice 4688642325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8777 Broadway
Merrillville, IN 46410-6693

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
56.64
Promoting interoperability
73
Improvement activities
40
Cost
76.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01045570AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Methodist Hospitals, Inc CurrentSince Jun 23, 2011 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Jun 23, 2011 Accepting new patients

Locations

27350 Network Pl
Chicago, IL 60673

4844 Broadway
Gary, IN 46408
Phone (219) 884-2400

3229 Broadway
#161
Gary, IN 46409
Phone (219) 887-7467

3229 Broadway
Ste 161
Gary, IN 46409
Phone (219) 887-1340

8777 Broadway
Ste 331
Merrillville, IN 46410

8777 Broadway
Merrillville, IN 46410
Phone (219) 736-5151

200 E 86th Pl
Merrillville, IN 46410
Phone (219) 649-2750

8777 Broadway
Ste C
Merrillville, IN 46410
Phone (219) 738-3550

5800 Broadway
Merrillville, IN 46410
Phone (219) 884-9180

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

Interoperability endpoints

  • Direct secure messaging: abrown7426@themethodisthospitals.direct-ci.com

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 2

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1770553166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8777 BROADWAY",
            "address_2": "SUITE 331",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106693",
            "telephone_number": "219-738-3854",
            "fax_number": "219-738-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 HARRISON ST",
            "address_2": "SUITE 331",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102969",
            "telephone_number": "219-887-1340",
            "fax_number": "219-887-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANGELIQUE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045570A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "207Q0000X",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "15D0938335",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S LICENSE #",
            "identifier": "01045570A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098750B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE #",
            "identifier": "01045570B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.