Shalom Health Care Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SHALOM HEALTH CARE CENTER, INC.

Practice address

3400 Lafayette Road
Suite 200
Indianapolis, IN 46222-1147

Phone

(317) 291-7422

Fax

(317) 291-7433

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Leonardo R Ortega, M.D., M.P.H.

Title

Executive Director

Phone

(317) 291-7422

Specialties & licenses 9

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN12 enrollments

Enrollment records 12

Federally qualified health center certification: CCN 151830

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 22, 2004

Last certification

Apr 22, 2004

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

4326 Patricia St
Indianapolis, IN 46222-1543

Federally qualified health center certification: CCN 151831

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 22, 2004

Last certification

Apr 22, 2004

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

3725 Kiel Ave
Room 105
Indianapolis, IN 46224-1228

Federally qualified health center certification: CCN 151839

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 13, 2005

Last certification

Jul 13, 2005

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

3400 Lafayette Rd
Ste 200
Indianapolis, IN 46222-1147

Federally qualified health center certification: CCN 151939

Legal name

SHALOM HEALTH CARE CENTER INC

Doing business as

STEPHEN FOSTER ELEMENTARY SCHOOL BASED CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 26, 2015

Last certification

Mar 26, 2015

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

653 N Somerset Ave
Indianapolis, IN 46222-3327

Federally qualified health center certification: CCN 151942

Legal name

SHALOM HEALTH CARE CENTER INC

Doing business as

INDIANA MATH AND SCIENCE ACADEMY NORTH SCHOOL BASED CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 7, 2015

Last certification

May 7, 2015

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

7435 N Keystone Ave
Indianapolis, IN 46240-4367

Federally qualified health center certification: CCN 151943

Legal name

SHALOM HEALTH CARE CENTER INC

Doing business as

INDIANA MATH AND SCIENCE ACADEMY WEST

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 18, 2015

Last certification

Apr 18, 2015

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

4575 W 38TH St
Indianapolis, IN 46254-3313

Federally qualified health center certification: CCN 151188

Legal name

SHALOM HEALTH CARE CENTER INC

Doing business as

IPS SCHOOL 46 - DANIEL WEBSTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 30, 2023

Last certification

Mar 30, 2023

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

1450 S Reisner St
Ste 100
Indianapolis, IN 46221-1637

Federally qualified health center certification: CCN C51050

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 9, 2024

Last certification

Aug 9, 2024

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 2002 in IN

Enrollment address

3401 N Meridian St
Indianapolis, IN 46208-4436

Federally qualified health center certification: CCN C51087

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 10, 2025

Last certification

Apr 10, 2025

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

1501 E 10TH St
Indianapolis, IN 46201-1909

Federally qualified health center certification: CCN C51093

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 9, 2025

Last certification

Jun 9, 2025

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

2215 W Washington St
Indianapolis, IN 46222-4279

Federally qualified health center certification: CCN C51120

Legal name

SHALOM HEALTH CARE CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 2, 2026

Last certification

Apr 2, 2026

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

5525 W 34TH St
RM 180
Indianapolis, IN 46224-1301

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1003275512

  3779471750

  Same PAC ID
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1770267486

  3779471750

  Same PAC ID

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1003275512

  O20040621000467

  Same enrollment
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1538167036

  O20040621000467

  Same enrollment
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1770267486

  O20040621000467

  Same enrollment
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1982242327

  O20040621000467

  Same enrollment

Locations

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Lyndsey Adams Furry, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1467822536

  W-2 Managing Employee

  CMS ownership
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1003275512

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Shalom Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1770267486

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Margarita Arkadiy Wiersema, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1083806608

  W-2 Managing Employee

  CMS ownership
• Arielle Zerger

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1265018220

  Corporate Director

  CMS ownership

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ariane Brennan, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1164125928

  Family, IN

  Medicare reassignment Care Compare group NPD
• Lyle R Cortez, D.O.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1295960805

  Family Medicine, IN

  Medicare reassignment Care Compare group NPD
• Stephen Kyle Rogers, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1609879675

  Family Medicine, IN

  Medicare reassignment Care Compare group NPD
• Tyler Trabel, PA-C

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1154891133

  IN, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Lyndsey Adams Furry, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1467822536

  IN

  Medicare reassignment Care Compare group
• Erica Becker, RN

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
  • NPI 1366056426

  IN, Pediatrics

  Medicare reassignment NPD
• Lori S Fishburn, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Franklin, IN
  • NPI 1922544584

  Family, IN

  Medicare reassignment NPD
• Kylie Ann Fletcher, NP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
  • NPI 1174252159

  IN, Pediatrics

  Medicare reassignment NPD
• Arthur A Galstian, M.D., LLC

  • Specialist
  • Indianapolis, IN
  • NPI 1407845795

  IN

  Medicare reassignment NPD
• Laura Garcia, PA-C

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1982201638

  Family Medicine, IN

  Medicare reassignment NPD
• Rachel Erin Ebert Gilboy, CPNP-PC

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
  • NPI 1760116040

  IN, Pediatrics

  Medicare reassignment NPD
• Andrea Hoskins, NP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1316544166

  Family, IN

  Medicare reassignment NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1992924633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE ROAD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LAFAYETTE ROAD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221147",
            "telephone_number": "317-291-7422",
            "fax_number": "317-291-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "317-291-7422",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family 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": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200392480",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise L. Shalkowski, NP
• Shalom Health Care Center, Inc.
• Shalom Health Care Center, Inc.
• Shalom Health Care Center, Inc.
• Shalom Health Care Center, Inc.
• Man Kung James Sham
• Catherine Shamblen, MD
• Alaa Shammah, M.D
• Issa Shammas, MD
• Sereen Shamoun

• All providers in Indianapolis, IN
• Federally Qualified Health Center (FQHC) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.