Manuel Suela Ozoa, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01033689A Issued in IN

Practice address

3903 Indianapolis Blvd
East Chicago, IN 46312-2555

Phone

(219) 398-7050

Fax

(219) 392-6998

NPI assigned

Aug 15, 2005

Last updated

May 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Psychiatry

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeastern Center IncGroup PAC ID 6709795636, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northeastern Center Inc

  dba Northeastern Center

  • Community/Behavioral Health Agency
  • Kendallville, IN
  • NPI 1720140908
  Medicare reassignment Care Compare group NPD
• Manuel Ozoa, M.D.

  • Psychiatry Physician
  • Highland, IN
  • NPI 1073523569
  NPD (past) Authorized official
• Northeastern Center, Inc

  dba Northeastern Center Inpatient

  • Psychiatric Hospital
  • Auburn, IN
  • NPI 1689781346
  NPD

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1881686020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANNA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-757-1928",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122555",
            "telephone_number": "219-398-7050",
            "fax_number": "219-392-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZOA",
        "first_name": "MANUEL",
        "middle_name": "SUELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01033689A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000352644",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oyebamiji Ohu, PMHNP-BC
• Okolocha Medical Pain & Weight Clinic
• Omni Med Solutions LLC
• Adebowale Osisanya, PMHNP-BC
• Leslie Owen, FNP-C
• Marie Packer, MD
• Yvette Paniagua, BA
• Kevin Parikh, MD
• Hyeri Park, PHARMD
• James W Parker, BA

• Psychiatry Physician in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.