Maryanhthu DO, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

02005724A Issued in IN

Practice address

801 Macarthur Blvd Ste 404
Munster, IN 46321-2919

Phone

(219) 836-2995

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 1998

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)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
• St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
• Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdo93617@ssdirect.comhs.org

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.

• Community Care Network Inc

  • Family Medicine Physician
  • St John, IN
  • NPI 1457610487

  Neurology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Stroke and Rehabilitation Center Inc

  • Rehabilitation Hospital
  • Crown Point, IN
  • NPI 1801301437

  Inpatient rehabilitation facility

  Care Compare affiliation
• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1689776882
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1912917659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11824 SOUTHWEST HWY",
            "address_2": "SUITE 100",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631055",
            "telephone_number": "708-361-0222",
            "fax_number": "708-361-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD STE 404",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212919",
            "telephone_number": "219-836-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11824 Southwest Hwy",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631055",
            "country_code": "US",
            "telephone_number": "708-361-0222",
            "fax_number": "708-361-4536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "MARYANHTHU",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036108812",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "02005724A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108812",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Ditusa, PA-C
• Anuradha Divakaruni, M.D.
• Shashidhar Divakaruni, M.D.
• Divine Home Health Services Inc
• Nikola Djorovic, D.D.S.
• Danielle Renee Dobkowski
• Marris Taylor Dobosz, RN
• Erica Dockens, LCSW, RN
• Reina Doetterl
• John Joseph Doherty, P.T., A.T.C.

• Neurology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.