Individual provider Active NPI

Polly Zeller, CRNA

  • Certified Registered Nurse Anesthetist
  • Munster, IN
National Provider Identifier
1871823930
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28172721A Issued in IN
Practice address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone
(219) 836-7040
Fax
(219) 513-1127
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28172721A IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2901

Mailing address

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-7040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000958 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012044241 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Indiana LLCGroup PAC ID 1153576905, 130 clinicians
Nwi Medical Associates , LLCGroup PAC ID 4183087257, 64 clinicians

Practice addresses (Care Compare)

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 703-1443

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Munster Medical Research Foundation Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 15, 2010 Accepting new patients
Munster Medical Research Foundation, Inc. CurrentSince Feb 15, 2010 Accepting new patients
St Catherine Hospital Inc Current Accepting new patients
Nwi Medical Associates , LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 25, 2024 Accepting new patients
St Catherine Hospital Inc CurrentSince Mar 15, 2019 Accepting new patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 19, 2020 Accepting new patients
St. Catherine Hospital Inc. CurrentSince Mar 15, 2019 Accepting new patients

Locations

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

12800 Mississippi Pkwy
Crown Point, IN 46307
Phone (219) 662-5560

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

Organizations & group practices 7

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 3

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": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1871823930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-7040",
            "fax_number": "219-513-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-7040",
            "fax_number": "219-513-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "POLLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28172721A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.