Mindy Kay Krsak, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71008698A Issued in IN

Practice address

3229 Broadway Ste 205
Gary, IN 46409-1038

Phone

(219) 806-3000

NPI assigned

Feb 6, 2019

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkrsak30469@themethodisthospitals.direct-ci.com

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.

• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment NPD
• Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1659196236
  NPD
• Porter Starke Services

  • Community/Behavioral Health Agency
  • Valparaiso, IN
  • NPI 1235365487
  NPD (past)
• Porter-Starke Services Inc.

  dba Marram Health Center

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1023485356
  NPD (past)
• Porter-Starke Services, Inc.

  dba Marram Health Center

  • Federally Qualified Health Center (FQHC)
  • Hebron, IN
  • NPI 1447815758
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1912462664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 BROADWAY STE 205",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091038",
            "telephone_number": "219-806-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 BROADWAY STE 205",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091038",
            "telephone_number": "219-806-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRSAK",
        "first_name": "MINDY",
        "middle_name": "KAY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71008698A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkrsak30469@themethodisthospitals.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3229 Broadway Ste 205",
            "city": "Gary",
            "state": "IN",
            "country_code": "US",
            "postal_code": "464091038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shaun Kirkendoll
• Diane Frances Kolarczyk, P.T.
• Kevin A. Komosa, LCSW
• Kool Smiles in-3, PC (Pippin Dental)
• Cory Kraus
• Aniket Girish Kulkarni
• Leslie Adjetey Kuma, M.D.
• Phillip James Kunz, M.D.
• Jihan La Broi
• Colette Labeaux

• Pediatric Nurse Practitioner in Gary, IN
• Providers in Gary, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.