Kumud Aggarwal, MD

Key facts

NPI

1992776546

Entity type

Individual (NPI type 1)

Primary specialty

Child & Adolescent Psychiatry Physician 2084P0804X

License

01028750A (IN)

Practice address

450 Saint John Rd
Suite 501
Michigan City, IN 46360-7354

Phone

(219) 879-4621

Fax

(219) 873-2388

NPI assigned

Jan 31, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 4

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.

• Healthlinc, Inc. Federally Qualified Health Center (FQHC) · Valparaiso, IN · NPI 1528262581
  Medicare reassignment NPD IN
• Laporte County Comprehensive Mental Health Council Mental Health Clinic/Center (Including Community Mental Health Center) · Michigan City, IN · NPI 1295746816
  Medicare reassignment NPD IN
• Healthlinc, Inc Federally Qualified Health Center (FQHC) · Morocco, IN · NPI 1568354116
  NPD
• Healthlinc, Inc. Federally Qualified Health Center (FQHC) · East Chicago, IN · NPI 1184069569
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 28, 2012.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1992776546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607354",
            "telephone_number": "219-879-4621",
            "fax_number": "219-873-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD",
            "address_2": "SUITE 501",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607354",
            "telephone_number": "219-879-4621",
            "fax_number": "219-873-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGGARWAL",
        "first_name": "KUMUD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01028750A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100163580A",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100139400A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Michigan City, IN · Child & Adolescent Psychiatry Physician in Indiana