Israel Nieto

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007936A Issued in IN

Practice address

4900 Broadway
Gary, IN 46408-4605

Phone

(219) 237-5170

Fax

(219) 321-1931

NPI assigned

May 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Karefirst Indiana PCGroup PAC ID 4587968862, 15 clinicians

Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: israel.nieto.d1.p1@direct.northshorehealth.nextgenshare.com

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Hanover, IN
  • NPI 1649770769

  IN

  Medicare reassignment Care Compare group NPD
• Valley Oaks Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, IN
  • NPI 1689629990

  IN

  Medicare reassignment Care Compare group NPD
• Karefirst Indiana PC

  • Nurse Practitioner
  • South Bend, IN
  • NPI 1639545882

  IN

  Medicare reassignment Care Compare group
• FC Indiana, LLC

  • Nurse Practitioner
  • Bedford, IN
  • NPI 1225579063

  IN

  Medicare reassignment NPD
• Northshore Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300

  IN

  Medicare reassignment NPD
• Southlake Community Mental Health Center Inc.

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290

  IN

  Medicare reassignment NPD
• FC Indiana, LLC

  • Rural Health Clinic/Center
  • Bedford, IN
  • NPI 1841911591
  NPD
• Northshore Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1023440526

  Family

  NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Midwest Express Care, Inc

  • Urgent Care Clinic/Center
  • Schererville, IN
  • NPI 1942642848
  NPD (past)

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1952890352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746721",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746721",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464084605",
            "telephone_number": "219-237-5170",
            "fax_number": "219-321-1931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10736 Randolph St",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IN",
            "postal_code": "463077983",
            "country_code": "US",
            "telephone_number": "931-253-1110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 S Nebraska St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469531874",
            "country_code": "US",
            "telephone_number": "765-664-7492",
            "fax_number": "844-397-1313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5818 Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "IN",
            "postal_code": "46320",
            "country_code": "US",
            "telephone_number": "219-237-5160",
            "fax_number": "219-321-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIETO",
        "first_name": "ISRAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007936A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Next Level Therapeutic Services LLP
• Alexis Katherine Neylon
• Nyaepu Ngwayah
• Nhi Home Base Service Corp.
• Yolana Nichols, LCMT
• Night Owl Inc. Home Care
• Northlake International Medical Laboratory
• Northshore Health Centers, Inc
• Northshore Health Centers, Inc.
• Northwest Center Medical Services Corp

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.