Active NPI
Michael F Mirochna, M.D.
- Family Medicine Physician
- Valparaiso, IN
National Provider Identifier
1770747263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11014818A
- Practice address
- 336 W US Highway 30
Suite a
Valparaiso, IN 46385-5345 - Phone
- (219) 464-7430
- Fax
- (219) 464-8014
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | AZ | ||
| Family Medicine Physician | 207Q00000X | 11014818A | IN | Primary |
Addresses
Primary practice location
336 W US Highway 30
Suite a
Valparaiso, IN 46385-5345
Mailing address
2022 Kelle Dr
Chesterton, IN 46304-8708
Phone (219) 364-3616
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | michael.mirochna.1@2340.direct.athenahealth.com |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110801000401 | IN | Practitioner - Family Practice | 8426227828 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Porter Physician Services LLC
Practice addresses (Care Compare)
2505 Calumet Ave
Valparaiso, IN 46383-2715
Phone (219) 548-3843
650 Dickinson Rd
Chesterton, IN 46304-3387
Hospital & facility affiliations
- Elara Caring
- Caretenders
- At Home Quality Care
- Powers Home Health Services
- Dunes Hospice LLC
- Vna Hospice Home Care
- Providence Hospice, Inc
- Northwest Health - Porter
- St Mary Medical Center Inc
- Franciscan Health Crown Point
- Franciscan Health Michigan City
- Avalon Springs Health Campus
- Life Care Center of the Willows
- Brickyard Healthcare - Valparaiso Care Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.68 of 100
- Quality
- 76.2
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11014818A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porter Physician Services LLC | Family Medicine | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients | |
| Porter Physician Services LLC | Family Medicine | Past | Accepting new patients |
Locations
2022 Kelle Dr
Chesterton, IN 46304
Phone (219) 364-3616
650 Dickinson Rd
Ste Z
Chesterton, IN 46304
Phone (219) 464-9507
650 Dickinson Rd
Ste A
Chesterton, IN 46304
Phone (219) 926-2133
401 Wall St
Unit F
Valparaiso, IN 46383
Phone (219) 462-2106
336 W US Highway 30
Ste A
Valparaiso, IN 46385
Phone (219) 464-7430
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Avalon Springs Health Campus | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Apr 15, 2025 Apr 15, 2025 |
| Life Care Center of the Willows | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Feb 1, 2019 Feb 1, 2019 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Valparaiso, IN
- NPI 1043582554
Adp of the SNF, Operational/Managerial Control
-
- Skilled Nursing Facility
- Valparaiso, IN
- NPI 1194772087
Adp of the SNF, Operational/Managerial Control
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Valparaiso, IN
- NPI 1508075680
Family Medicine, IN
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Internal Medicine Physician
- Portage, IN
- NPI 1457566309
Family Medicine
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Chesterton, IN
- NPI 1669540332
-
- General Acute Care Hospital
- Michigan City, IN
- NPI 1710051941
Hospital
-
- Home Health Agency
- Valparaiso, IN
- NPI 1013493493
-
- Community Based Hospice Care Agency
- Saint John, IN
- NPI 1548614910
Hospice
-
- Home Health Agency
- Hobart, IN
- NPI 1528160736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1770747263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2022 KELLE DR",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463048708",
"telephone_number": "219-364-3616",
"fax_number": "219-364-3610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 W US HIGHWAY 30",
"address_2": "SUITE A",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463855345",
"telephone_number": "219-464-7430",
"fax_number": "219-464-8014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIROCHNA",
"first_name": "MICHAEL",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11014818A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "michael.mirochna.1@2340.direct.athenahealth.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "336 W US Highway 30",
"address_2": "Suite A",
"city": "Valparaiso",
"state": "IN",
"country_code": "US",
"postal_code": "463855345",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.