NPIMap

Organization Active NPI

Vein Associates of Northwest Indiana LLC

  • Clinic/Center
  • Merrillville, IN
National Provider Identifier
1801217856
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
01052522A Issued in IN
Legal business name
VEIN ASSOCIATES OF NORTHWEST INDIANA LLC
Practice address
1000 E 80TH PL
Suite 308S
Merrillville, IN 46410-5608
Phone
(219) 736-8118
NPI assigned
Dec 18, 2013
Last updated
Apr 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Authorized official

Name
Amjad Alkadri, MDNPI 1407817513
Title
Ceo/Medical Director
Phone
(219) 736-8118

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
Clinic/Center 261Q00000X 01052522A IN Primary

Addresses

Primary practice location

1000 E 80TH PL
Suite 308S
Merrillville, IN 46410-5608

Mailing address

1000 E 80TH PL
Suite 308S
Merrillville, IN 46410-5608
Phone (219) 736-8118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140314001944 IN Part B Supplier - Clinic/Group Practice 3072744002 Receives reassigned benefits from 7 practitioners
Practice locations: Crown Point, IN; La Porte, IN; Rensselaer, IN; Valparaiso, IN

National Provider Directory

National Provider Directory

Locations

125 E Shore Pkwy
La Porte, IN 46350

3907 Calumet Ave
Valparaiso, IN 46383

3907 Calumet Ave
Ste 300
Valparaiso, IN 46383

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12167/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1801217856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 80TH PL",
            "address_2": "SUITE 308S",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105608",
            "telephone_number": "219-736-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 80TH PL",
            "address_2": "SUITE 308S",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105608",
            "telephone_number": "219-736-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN ASSOCIATES OF NORTHWEST INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "ALKADRI",
        "authorized_official_first_name": "AMJAD",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "219-736-8118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "01052522A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.