NPIMap

Individual provider Active NPI

Dominic Harris, MD

  • Neurological Surgery Physician
  • Munster, IN
National Provider Identifier
1912394883
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
01092666A Issued in IN
Practice address
801 Macarthur Blvd Ste 405
Munster, IN 46321-2919
Phone
(219) 836-5167
Fax
(219) 836-5249
NPI assigned
Apr 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 01092666A IN Primary

Addresses

Primary practice location

801 Macarthur Blvd Ste 405
Munster, IN 46321-2919

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (193) 927-0842

Other identifiers 1

IdentifierTypeStateIssuer
300087072MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240530002495 IN Practitioner - Neurosurgery 6709190622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Chicago, Pritzker School of Medicine, 2015
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)

801 Macarthur Blvd
Suite 405
Munster, IN 46321-2919
Phone (219) 836-5167

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion29
Laminectomy or laminotomy (partial removal of spine bones)13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Neurological Surgery CurrentSince Jul 1, 2024 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

801 MacArthur Blvd
Ste 405
Munster, IN 46321
Phone (219) 836-5040

1545 W US Highway 30
Schererville, IN 46375
Phone (219) 703-2440

1545 W US Highway 30
Fl 2
Schererville, IN 46375

Interoperability endpoints

  • Direct secure messaging: dharris161168@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 8

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": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1912394883",
    "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": "193-927-0842",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD STE 405",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212919",
            "telephone_number": "219-836-5167",
            "fax_number": "219-836-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01092666A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300087072",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.