NPIMap

Organization Active NPI

Pinnacle Healthcare, LLC

Doing business as Lake Orthopedic and Spine

  • Multi-Specialty Clinic/Center
  • Merrillville, IN
National Provider Identifier
1922546530
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PINNACLE HEALTHCARE, LLC
Doing business as
Lake Orthopedic and Spine
Practice address
8550 Broadway
Merrillville, IN 46410-7173
Phone
(219) 795-1890
NPI assigned
Feb 2, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Haroon Rashid Ansari
Title
Ceo
Phone
(219) 796-4103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

8550 Broadway
Merrillville, IN 46410-7173

Mailing address

9301 Connecticut Dr
Crown Point, IN 46307-7486
Phone (219) 756-2100

Other practice location 1

502 Wall St
Valparaiso, IN 46383-2584
Phone (219) 462-9937

Other names 1

  • Lake Orthopedic and Spine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080430000005 IN Part B Supplier - Clinic/Group Practice 1254331184 Receives reassigned benefits from 29 practitioners
2 other NPIs on this enrollment
Practice locations: Crown Point, IN; Mishawaka, IN; Lowell, IN

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

957 E Commercial Ave
Lowell, IN 46356
Phone (219) 690-3779

502 Wall St
Valparaiso, IN 46383
Phone (219) 464-9982

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pinnacle HospitalCrown Point, IN, CCN 150166 Hospital 5% Or Greater Direct Ownership Interest Apr 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1922546530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 CONNECTICUT DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077486",
            "telephone_number": "219-756-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107173",
            "telephone_number": "219-795-1890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Wall St",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832584",
            "country_code": "US",
            "telephone_number": "219-462-9937",
            "fax_number": "219-531-0859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINNACLE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "ANSARI",
        "authorized_official_first_name": "HAROON",
        "authorized_official_middle_name": "RASHID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-796-4103",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Orthopedic and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.