Altea Medical Indiana PC
Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Gary, IN
NPI 1992584783 · NPPES record last updated Nov 17, 2025
Key facts
- NPI
- 1992584783
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 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
- Organization subpart
- No
Authorized official
- Name
- Lisa Krueger
- Title
- VP of Revenue Cycle
- Phone
- (888) 408-7008
Owned or controlled facilities with NPI records 4
Practitioners 85
-
Brenda Ann Anderson, MSN FNP
-
Jessica J Baker, AGNP
-
Abigail G Boris, APRN
-
Monica S Broo, NP
-
Jenna Starr Fleck, AGPCNP-BC
-
Jennifer Ann Holcomb, AGNP
-
Micahl Holloway, APRN
-
Chijioke A. Kalu, M.D.
-
Jessica Kane, NP-F
-
Paul N Kuria, DNP
-
Aliza Mazhar, MD
-
Bryon W Miller, MSN RNC
-
Erin O'Donnell, FNP-C
-
Thomas Edwin Puckett Jr., N.P.
-
Kristin A Teter, NP
-
Erin Tofani, APRN
-
Lorrie A White, FNP-C
-
Autumn Kathryn Montgomery, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Northview Health and Living |
Skilled nursing facility | Adp of the SNF | Jun 21, 2024 |
| Summit Health and Living |
Skilled nursing facility | Adp of the SNF | Jun 21, 2024 |
| Elwood Health and Living |
Skilled nursing facility | Adp of the SNF | Jun 21, 2024 |
| Envive of Muncie |
Skilled nursing facility | Operational/Managerial Control | Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240506001301 | IN | Part B Supplier - Clinic/Group Practice | 4183064389 | Receives reassigned benefits from 85 practitioners |
National Provider Directory
Locations
1850 W Matador St
Peru, IN 46970
Phone (765) 689-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician |
207QA0505X | |||
| Internal Medicine Physician |
207R00000X | |||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | Yes | ||
| Physical Medicine & Rehabilitation Physician |
208100000X |
Addresses
Primary practice location
2350 Taft St
Gary, IN 46404-3349
Mailing address
400 E Rivulon Blvd Ste 103
Gilbert, AZ 85297-0096
Other providers in Gary, IN
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- Eunice Ngozi Amazigo
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All providers in Gary, IN · Geriatric Medicine (Internal Medicine) Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.