Midwest Express Care 4, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MIDWEST EXPRESS CARE 4, LLC

Doing business as

Midwest Express Clinic

Practice address

1009 5TH Ave
Hammond, IN 46320-1004

Phone

(219) 473-0722

NPI assigned

Nov 9, 2021

Last updated

Nov 9, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MIDWEST EXPRESS CARE 4, LLCAs reported in NPPES

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

Authorized official

Name

Milap Shah

Title

Owner

Phone

(219) 802-8800

Specialties & licenses 1

Addresses

Other names 1

• Midwest Express Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Merrillville, IN
  • NPI 1255178125

  4284909615

  Same PAC ID
• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Merrillville, IN
  • NPI 1619536067

  4284909615

  Same PAC ID
• Midwest Express Care 4 LLC

  dba Midwest Express Clinics

  • Urgent Care Clinic/Center
  • Hammond, IN
  • NPI 1629502810

  4284909615

  Same PAC ID
• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Portage, IN
  • NPI 1962249839

  4284909615

  Same PAC ID
• Midwest Express Care 4, LLC

  dba Midwest Express Clinic

  • Urgent Care Clinic/Center
  • Griffith, IN
  • NPI 1811571052

  4284909615

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Midwest Express Care 4 LLC

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1912663501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775342",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 5TH AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201004",
            "telephone_number": "219-473-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EXPRESS CARE 4, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST EXPRESS CARE 4, LLC",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MILAP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-802-8800"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Express Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alonzo Benjamin Mendoza, RPH
• Mental Health America of Lake County, Inc (Mental Health America of Northwest Indiana)
• Juleon Meredith, ED.S
• Ronald Michael, M.D.
• Midwest Express Care 4 LLC (Midwest Express Clinics)
• Kelly Jean Mis, CRNA
• Lynn Marie Miskovich, APN
• Yomesha Mitchell, BODYSCULPTER
• Krishn Mohan, M.D.
• Omar Mohiuddin

• Urgent Care Clinic/Center in Hammond, IN
• Providers in Hammond, IN by specialty
• Urgent Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.