AUSTIN TYLER QUALIZZA (NPI# 1639778970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639778970 |
| Entity Type | Individual |
| Full Name | AUSTIN TYLER QUALIZZA |
| Credential | PA-C |
| Practice Address |
601 Gateway Blvd N Chesterton IN 46304-9658 |
| Practice Telephone | 2199211444 |
| Practice Fax Number | 2199266926 |
| Mailing Telephone | 2199211444 |
| Mailing Fax Number | 2192505256 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12800 Mississippi Pkwy Ste 201, Crown Point, IN 463076900 | 2199211444 | 2199266926 |
| 833 W Lincoln Hwy Ste 110, Schererville, IN 463751674 | 2199211444 | 2199266926 |
| Street Address |
601 GATEWAY BLVD N |
| City | CHESTERTON |
| State | IN |
| Zip Code | 46304-9658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295733889 | Paul J Gruszka | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2005-07-08 |
| 1477184281 | Julia M Campbell | Occupational Therapist | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2020-01-30 |
| 1609438910 | Ma Carmel Quijada Breidigan | Registered Nurse | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2019-07-08 |
| 1962984294 | Megan Vittetoe | Nurse Practitioner | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2018-09-04 |
| 1841790672 | Cassie R Layne | Nurse Practitioner | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2018-02-19 |
| 1760992986 | Seth R Hardy | Physical Therapy Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2017-10-02 |
| 1598275711 | Jodi King | Physical Therapy Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2017-10-02 |
| 1689038432 | Donna Persin | Physical Therapy Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2016-04-07 |
| 1235598939 | Alice Hawkins | Physical Therapy Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2016-02-23 |
| 1437518107 | Eric Gatewood | Physical Therapy Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2016-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274268 | Trinity Healthcare Inc. | Occupational Therapist | 2300 Village Point, Chesterton, IN 46304 | 2019-09-19 |
| 1962987206 | Kara Polus | Physical Therapy Assistant | 1595 S Calumet Rd Suite 3, Chesterton, IN 46304 | 2018-10-02 |
| 1275024481 | Karson Rice | Developmental Therapist | 1595 S Calumet Rd, Suite 3, Chesterton, IN 46304 | 2018-05-23 |
| 1720527765 | Alina Broski I | Occupational Therapy Assistant | 1120 S. Calument Road, Suite 3, Chesterton, IN 46304 | 2017-02-22 |
| 1538612015 | Muhammad Ziad Souqiyyeh | Internal Medicine | 3100 Village Pt Ste 102, Chesterton, IN 46304 | 2016-08-01 |
| 1942671656 | Samantha Stremich | Psychologist | 1496 Pope Ct # 2, Chesterton, MI 46304 | 2015-10-08 |
| 1669852299 | Deborah Joan Krause | Physical Therapy Assistant | 780 Dickinson Rd., Addison Pointe Health & Rehab Center, Chesterton, IN 46304 | 2015-06-09 |
| 1538462338 | Sunil Patel Md. P.C. | Internal Medicine | 1140 S. Calumet Road, Suite #2, Chesterton, IN 46304 | 2010-12-16 |
| 1629301981 | Lindsay Allison Munden | Nurse Practitioner | 505 County Road 1100 North, Chesterton, IN 46304 | 2009-09-17 |
| 1881851509 | Total Renal Care Inc | Clinic/Center | 711 Plaza Dr, Ste 6, Chesterton, IN 46304 | 2008-05-20 |
| Find all providers in zip 46304 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073952677 | Gage Alan Thoma | Physician Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2013-06-18 |
| 1356602460 | Daniel W Balcerak | Physician Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2012-06-05 |
| 1194016881 | Danielle Mankin | Physician Assistant | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2011-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133894 | Kaylin Michelle Lapel | Physician Assistant | 1540 Orchard Park Dr N, Carmel, IN 46280-1513 | 2020-11-01 |
| 1639779739 | Brock Sokolowski | Physician Assistant | 4581 Nikki Dr Apt D, Indianapolis, IN 46237-1703 | 2020-10-28 |
| 1699373357 | Dillon Etter | Physician Assistant | 2848 N Delaware St, Indianapolis, IN 46205-4118 | 2020-10-15 |
| 1417555996 | Kathleen Wiles | Physician Assistant | 3805 Pine Creek Cir, New Albany, IN 47150-2057 | 2020-10-15 |
| 1962017210 | Taylor Lee Bowen | Physician Assistant | 2760 Woodwind Way, Indianapolis, IN 46268-4233 | 2020-09-14 |
| 1275148421 | James Cameron Fields | Physician Assistant | 532 Bridgestone Dr, Mooresville, IN 46158-7304 | 2020-09-14 |
| 1912512476 | William Terrell Parmenter | Physician Assistant | 2230 English Ave, Indianapolis, IN 46201-4017 | 2020-09-11 |
| 1457966376 | Angela Shearon | Physician Assistant | 4325 N College Ave, Indianapolis, IN 46205-1931 | 2020-09-09 |
| 1831702570 | Nathan Dean Hailey | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 247, Avon, IN 46123-6911 | 2020-08-24 |
| 1104438944 | Erin R Griffin | Physician Assistant | 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 | 2020-08-22 |
| Find all providers with the same taxonomy | ||||
| City | CHESTERTON |
| Zip Code | 46304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.