Individual provider Active NPI

Adam Joseph Nieman, PA-C

  • Surgical Physician Assistant
  • Crown Point, IN
National Provider Identifier
1801768049
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10005047A Issued in IN
Practice address
500 E 109TH Ave
Crown Point, IN 46307-7294
Phone
(219) 921-1444
Fax
(219) 921-5303
NPI assigned
Sep 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10005047A IN Primary
Physician Assistant 363A00000X 10005047A IN

Addresses

Primary practice location

500 E 109TH Ave
Crown Point, IN 46307-7294

Mailing address

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Other practice location 1

3691 Willowcreek Rd
Portage, IN 46368-5080
Phone (219) 921-1444

Other practice location 2

833 W Lincoln Hwy Ste 110E
Schererville, IN 46375-4606
Phone (219) 921-1444

Other practice location 3

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

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
I20251029001584 IN Practitioner - Physician Assistant 4587153648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone (219) 921-1444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10005047AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Bone & Joint Institute, PC CurrentSince Oct 16, 2025 Accepting new patients

Locations

601 Gateway Blvd N
Chesterton, IN 46304
Phone (219) 921-1401

500 E 109th Ave
Crown Point, IN 46307

3777 N Frontage Rd
Ste 900
Michigan City, IN 46360
Phone (219) 879-6021

3691 Willowcreek Rd
Portage, IN 46368
Phone (219) 759-4380

3691 Willowcreek Rd
Ste 100
Portage, IN 46368
Phone (219) 759-4380

833 W Lincoln Hwy
Ste 110E
Schererville, IN 46375
Phone (219) 427-0700

2501 Cumberland Dr
Valparaiso, IN 46383
Phone (219) 462-4481

Organizations & group practices 1

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": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1801768049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GATEWAY BLVD N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049658",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 109TH AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077294",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3691 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685080",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 W Lincoln Hwy Ste 110E",
            "address_purpose": "LOCATION",
            "city": "Schererville",
            "state": "IN",
            "postal_code": "463754606",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Gateway Blvd N",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463049658",
            "country_code": "US",
            "telephone_number": "219-921-1444",
            "fax_number": "219-921-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10005047A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005047A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.