Individual provider Active NPI

Kumud Aggarwal, MD

  • Child & Adolescent Psychiatry Physician
  • Michigan City, IN
National Provider Identifier
1992776546
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
01028750A Issued in 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
Last updated
Feb 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 01028750A IN Primary

Addresses

Primary practice location

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

Mailing address

450 Saint John Rd
Michigan City, IN 46360-7354
Phone (219) 879-4621

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111227000524 IN Practitioner - Psychiatry 1557536653 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. CurrentSince May 1, 2016 Accepting new patients
Laporte County Comprehensive Mental Health Council CurrentSince Aug 23, 1978 Accepting new patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince May 1, 2016 Accepting new patients

Locations

450 St John Rd
Michigan City, IN 46360
Phone (219) 879-0676

450 St John Rd
Ste 501
Michigan City, IN 46360
Phone (219) 879-0676

7224 W 400 N
Michigan City, IN 46360
Phone (219) 879-4621

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.