Individual provider Active NPI

Meaghan Renee Misiasz, MD

  • Allergy & Immunology Physician
  • Munster, IN
National Provider Identifier
1821316621
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
01087414A Issued in IN
Practice address
929 Ridge Rd Ste 1
Munster, IN 46321-1769
Phone
(219) 703-2418
Fax
(219) 836-2433
NPI assigned
May 4, 2010
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Allergy & Immunology Physician 207K00000X DR.0057440 CO
Allergy & Immunology Physician 207K00000X 01087414A IN Primary

Addresses

Primary practice location

929 Ridge Rd Ste 1
Munster, IN 46321-1769

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other practice location 1

5818 N Nevada Ave Ste 200
Colorado Springs, CO 80918-3505
Phone (719) 364-2554

Other practice location 2

16222 West Highway 24
Suite 210
Woodland Park, CO 80863-8763
Phone (719) 364-2554

Other practice location 3

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-5352

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405002783 IN Practitioner - Allergy/Immunology 4486943107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

929 Ridge Rd
Suite 1
Munster, IN 46321-1769
Phone (219) 836-6241

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0057440COMDAllergy & Immunology Physician
01087414AINMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Apr 1, 2022 Accepting new patients

Locations

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

929 Ridge Rd
Ste 1
Munster, IN 46321
Phone (219) 703-2418

Interoperability endpoints

  • Direct secure messaging: mmisiasz129801@ssdirect.comhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1821316621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 RIDGE RD STE 1",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211769",
            "telephone_number": "219-703-2418",
            "fax_number": "219-836-2433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5818 N Nevada Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809183505",
            "country_code": "US",
            "telephone_number": "719-364-2554",
            "fax_number": "719-364-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16222 West Highway 24",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Woodland Park",
            "state": "CO",
            "postal_code": "808638763",
            "country_code": "US",
            "telephone_number": "719-364-2554",
            "fax_number": "719-364-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1653 W Congress Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123833",
            "country_code": "US",
            "telephone_number": "312-942-5352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISIASZ",
        "first_name": "MEAGHAN",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CO",
            "license": "DR.0057440",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IN",
            "license": "01087414A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.