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Organization Active NPI

Altea Medical Indiana PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gary, IN
National Provider Identifier
1992584783
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
ALTEA MEDICAL INDIANA PC
Practice address
2350 Taft St
Gary, IN 46404-3349
Phone
(888) 408-7008
NPI assigned
Sep 21, 2023
Last updated
Nov 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Lisa Krueger
Title
VP of Revenue Cycle
Phone
(888) 408-7008

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

2350 Taft St
Gary, IN 46404-3349

Mailing address

400 E Rivulon Blvd Ste 103
Gilbert, AZ 85297-0096

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240506001301 IN Part B Supplier - Clinic/Group Practice 4183064389 Receives reassigned benefits from 85 practitioners

National Provider Directory

National Provider Directory

Locations

1235 W Cross St
Anderson, IN 46011
Phone (765) 298-2534

1745 E 67th St
Anderson, IN 46013
Phone (317) 782-1577

601 N Boeke Rd
Evansville, IN 47711
Phone (812) 476-4912

715 N Mill St
Hartford City, IN 47348
Phone (765) 348-2273

1924 Wellesley Blvd
Indianapolis, IN 46219
Phone (317) 262-0950

8201 W Washington St
Indianapolis, IN 46231
Phone (317) 221-2000

6712 Restoracy Dr
Whitestown, IN 46075
Phone (317) 313-3239

Ownership & related parties

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Northview Health and LivingAnderson, IN, CCN 155718 Skilled nursing facility Adp of the SNF Jun 21, 2024
Summit Health and LivingSummitville, IN, CCN 155839 Skilled nursing facility Adp of the SNF Jun 21, 2024
Elwood Health and LivingElwood, IN, CCN 155522 Skilled nursing facility Adp of the SNF Jun 21, 2024
Envive of MuncieMuncie, IN, CCN 155549 Skilled nursing facility Operational/Managerial Control Jan 1, 2025

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 85

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 85

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1992584783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RIVULON BLVD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 TAFT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464043349",
            "telephone_number": "888-408-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTEA MEDICAL INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "888-408-7008"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.