Individual provider Active NPI

Melanie Lynn Haney, NP

  • Family Nurse Practitioner
  • Portage, IN
National Provider Identifier
1851437859
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71002265A Issued in IN
Practice address
3190 Lancer St
Portage, IN 46368-4488
Phone
(219) 764-3600
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71002265A IN Primary

Addresses

Primary practice location

3190 Lancer St
Portage, IN 46368-4488

Mailing address

1452 W 73Rd PL
Merrillville, IN 46410-4619
Phone (219) 769-6889

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
I20110516000782 IN Practitioner - Nurse Practitioner 0547446130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

3190 Lancer St
Portage, IN 46368-4488
Phone (219) 764-3600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002265AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Dermatology Institute, LLC CurrentSince Jan 1, 2013 Accepting new patients
Decatur Memorial Hospital Past Accepting new patients
Northern Indiana Dermatology and Skin Surgery Center Past Accepting new patients

Locations

2622 Momentum Pl
Chicago, IL 60689

9601 Calumet Ave
Ste E
Munster, IN 46321
Phone (219) 491-3376

3190 Lancer St
Portage, IN 46368
Phone (219) 764-3600

3190 Lancer St
#A
Portage, IN 46368
Phone (219) 764-3600

3190 Lancer St
Ste 101
Portage, IN 46368

Organizations & group practices 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851437859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 W 73RD PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464104619",
            "telephone_number": "219-769-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 LANCER ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684488",
            "telephone_number": "219-764-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "MELANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002265A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

Verify at the official NPI Registry.