Emmanuel Thierry Mentor

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01073933A Issued in IN

Practice address

650 Dickinson Rd
Chesterton, IN 46304-3387

Phone

(219) 926-7755

Fax

(219) 929-1885

NPI assigned

Mar 6, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hansa Medical Groupe PLLC 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dunes Hospice LLC Hospice, Valparaiso, IN, CCN 151614

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Hansa Medical Groupe PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1386804615

  IN

  Medicare reassignment Care Compare group NPD
• Hansamssp LLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1013700541

  IN

  Medicare reassignment NPD
• Ny Long-Term Care Physician Services, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Uniondale, NY
  • NPI 1477121549

  IN

  Medicare reassignment NPD
• Vohra Wound Physicians of the West, P.C.

  • Family Medicine Physician
  • Englewood, CO
  • NPI 1205176096

  Family Medicine, IN

  Medicare reassignment NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Dunes Hospice LLC

  • Community Based Hospice Care Agency
  • Valparaiso, IN
  • NPI 1609280015

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1770909392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 LAPORTE AVE",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835801",
            "telephone_number": "219-263-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DICKINSON RD",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043387",
            "telephone_number": "219-926-7755",
            "fax_number": "219-929-1885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685075",
            "country_code": "US",
            "telephone_number": "219-364-3900",
            "fax_number": "219-364-3959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 LaPorte Ave",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463835801",
            "country_code": "US",
            "telephone_number": "219-263-4977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTOR",
        "first_name": "EMMANUEL THIERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01073933A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek McMahan, PT
• Marisela Magdalena Medina
• Anita M Medrano, PTA
• Cameron Meekma, RBT
• Rebecca Mendyke, MOT, OTR/L
• Francesca Ana Metlov, PA-C
• Mary Ann Meyer Jones, M.D.
• Midwest Eye Consultants, P.C.
• Kara Brooke Miecznikowski
• Ann Marie Mika, CCC-SLP

• All providers in Chesterton, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.