Individual provider Active NPI

Diana Rose Poortenga

  • Registered Nurse
  • Munster, IN
National Provider Identifier
1780207332
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28213590A Issued in IN
Practice address
8135 Calumet Ave
Munster, IN 46321-1701
Phone
(219) 513-2000
NPI assigned
May 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28213590A IN Primary

Addresses

Primary practice location

8135 Calumet Ave
Munster, IN 46321-1701

Mailing address

8135 Calumet Ave
Munster, IN 46321-1701
Phone (219) 513-2000

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
I20200730000367 IN Practitioner - Nurse Practitioner 9335564962 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians
Midwest Express Care, IncGroup PAC ID 5193957595, 31 clinicians
Nwi Urgent Care, LLCGroup PAC ID 7618142977, 45 clinicians

Practice addresses (Care Compare)

129 E 107TH Ave
Crown Point, IN 46307-6517
Phone (219) 662-4134

1500 Indianapolis Blvd
Schererville, IN 46375-1316
Phone (219) 440-7373

1923 W Glen Park Ave
Griffith, IN 46319-3703
Phone (219) 922-2535

31 E Sibley St
Suite a
Hammond, IN 46320-1725
Phone (219) 802-8800

5043 E 81St Ave
Merrillville, IN 46410-5912
Phone (219) 554-3290

5521 W Lincoln Hwy
Suite 1a
Crown Point, IN 46307-1098
Phone (219) 769-1362

6131 US Hwy 6
Portage, IN 46368-5058
Phone (219) 841-9788

7890 E Ridge Rd
Hobart, IN 46342-2468
Phone (219) 788-1237

8135 Calumet Ave
Munster, IN 46321-1701
Phone (219) 513-2000

875 Joliet St
Dyer, IN 46311-1920
Phone (219) 440-7340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28213590AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Urgent Care, LLC CurrentSince Jul 7, 2020 Accepting new patients
The Methodist Hospitals, Inc PastSince May 24, 2020 Accepting new patients

Locations

5521 W US Highway 30
Ste 1A
Crown Point, IN 46307
Phone (219) 769-1362

31 Sibley St
Ste A
Hammond, IN 46320
Phone (219) 802-8800

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1780207332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORTENGA",
        "first_name": "DIANA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28213590A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.