NPIMap

Individual provider Active NPI

Mark A Feldner, MD

  • Family Medicine Physician
  • Saint John, IN
National Provider Identifier
1952300873
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01035622A Issued in IN
Practice address
9660 Wicker Ave
St John, IN 46373-9487
Phone
(219) 365-1166
Fax
(219) 365-8852
NPI assigned
Jul 21, 2005
Last updated
Jun 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01035622A IN Primary

Addresses

Primary practice location

9660 Wicker Ave
St John, IN 46373-9487

Mailing address

9660 Wicker Ave
St John, IN 46373-9487
Phone (219) 365-1166

Other identifiers 3

IdentifierTypeStateIssuer
000000081296OtherINANTHEM BCBS
080179938OtherINMEDICARE RAILROAD
100096890MedicaidIN

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
I20100113000901 IN Practitioner - Family Practice 0749321669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
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)

9660 Wicker Ave
Saint John, IN 46373-9487
Phone (219) 365-1166

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01035622AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Chest Physician Consultants, LTD Past Accepting new patients

Locations

6625 W Lincoln Hwy
Ste 4
Crown Point, IN 46307
Phone (219) 515-6458

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

10240 Calumet Ave
Munster, IN 46321
Phone (219) 440-5286

10240 Calumet Ave
Fl 2
Munster, IN 46321
Phone (219) 836-8100

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9307 Calumet Ave
Ste A2
Munster, IN 46321
Phone (219) 836-2274

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

7651 Harvest Dr
Schererville, IN 46375
Phone (219) 322-5723

1451 Morthland Dr
Ste A
Valparaiso, IN 46385
Phone (219) 286-3880

3800 Saint Mary Rd
Ste 102
Valparaiso, IN 46383
Phone (219) 286-3707

Interoperability endpoints

  • Direct secure messaging: mfeldner1502@ssdirect.comhs.org

Organizations & group practices 2

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 9

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1952300873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9660 WICKER AVE",
            "city": "ST JOHN",
            "state": "IN",
            "postal_code": "463739487",
            "telephone_number": "219-365-1166",
            "fax_number": "219-365-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9660 WICKER AVE",
            "city": "ST JOHN",
            "state": "IN",
            "postal_code": "463739487",
            "telephone_number": "219-365-1166",
            "fax_number": "219-365-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDNER",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01035622A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000081296",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080179938",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint John, IN

Sources for this page

Verify at the official NPI Registry.