ST. MARY MEDICAL CENTER (NPI# 1700921541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700921541 |
| Entity Type | Organization |
| Organization Name | ST. MARY MEDICAL CENTER |
| Practice Address |
2241 45th St Highland IN 46322-2601 |
| Mailing Address |
164 Bracken Pkwy Hobart IN 46342-6789 |
| Practice Telephone | 2197381736 |
| Mailing Telephone | 2199476780 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-03-26 |
| Authorized Official Name | MARY F SUDICKY (CFO) |
| Authorized Official Telephone | 2199420551 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669456299 | St. Mary Medical Center | General Acute Care Hospital | 18300 Highway 18, Apple Valley, CA 92307 | 2005-12-06 |
| 1285007419 | St. Mary Medical Center | Clinic/Center | 1045 Atlantic Ave, Suite 914, Long Beach, CA 90813-3408 | 2015-11-10 |
| 1740698497 | St. Mary Medical Center | General Acute Care Hospital | 1707 N Henderson St, Galesburg, IL 61401-1320 | 2014-07-25 |
| 1487078796 | St. Mary Medical Center | Ambulance | 1201 Langhorne Newtown Rd, Langhorne, PA 19047-1201 | 2014-02-06 |
| 1043406440 | St. Mary Medical Center | Advanced Practice Midwife | 18077 Us Highway 18, Apple Valley, CA 92307-2150 | 2007-09-19 |
| 1982899266 | St. Mary Medical Center | General Acute Care Hospital | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2007-09-11 |
| 1952458564 | St. Mary Medical Center | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2007-01-04 |
| 1457425605 | St. Mary Medical Center | Internal Medicine | 300 W 80th Pl, Ste A, Merrillville, IN 46410-5456 | 2006-11-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER | 1201 Langhorne - Newtown Rd, Langhorne, PA 19047-1201 |
| Washington State Corporations | ST. MARY MEDICAL CENTER | 401 W Poplar St, Walla Walla, WA 99362 |
| Indiana Business Entities | ST. MARY MEDICAL CENTER DEVELOPMENT, LLC | St. Mary Medical Center, 1500 S. Lake Park Ave., Hobart, IN 46342 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER FOUNDATION | 1050 Linden Ave, Long Beach, CA 90813-3321 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER, INC. | 1500 S Lake Park Ave, Hobart, IN 46342-6638 |
| Street Address |
2241 45TH ST |
| City | HIGHLAND |
| State | IN |
| Zip Code | 46322-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518054352 | Mary Tilak | Internal Medicine | 2241 45th St, Highland, IN 46322-2601 | 2006-10-05 |
| 1437784451 | Bethany Michaelis | Nurse Practitioner | 2241 45th St, Highland, IN 46322-2601 | 2020-03-10 |
| 1992272405 | Samantha Nicole Lewis | Nurse Practitioner | 2241 45th St, Highland, IN 46322-2601 | 2018-11-01 |
| 1871039875 | Michelle Lynn Masterson | Nurse Practitioner | 2241 45th St, Highland, IN 46322-2601 | 2017-01-13 |
| 1023462488 | Kelly Leigh Tarr | Dietitian, Registered | 2241 45th St, Highland, IN 46322-2601 | 2016-04-21 |
| 1629447891 | Elizabeth Case | Nurse Practitioner | 2241 45th St, Highland, IN 46322-2601 | 2015-09-17 |
| 1871922740 | Nelli Khallak | Nurse Practitioner | 2241 45th St, Highland, IN 46322-2601 | 2013-11-01 |
| 1003096900 | Dr Mary Tilak P C | Internal Medicine | 2241 45th St, Highland, IN 46322-2601 | 2007-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431733 | Marielva Banks | Physician Assistant | 10343 Indianapolis Blvd Ste 104, Highland, IN 46322 | 2017-08-03 |
| 1467806596 | Archangel Home Care Inc | Home Health | 2148 45th Ste 205, Highland, IN 46322 | 2016-04-14 |
| 1427457886 | Veronica Addison | Community/Behavioral Health | 219 Indianapolis Blvd, Ste B, Highland, IN 46322 | 2014-08-21 |
| 1750700423 | Persa Darnell | Nurse Practitioner | 3747 45th Ave., Highland, IN 46322 | 2014-04-10 |
| 1043648207 | Wahbi Adad | Specialist | 8732 Woodward Ave, Highland, IN 46322 | 2013-10-28 |
| 1619229317 | Cleotis White | Counselor | 2646 Highway Ave Ste 108, Highland, IN 46322 | 2012-10-05 |
| 1912278904 | Noble Home Health Care LLC | Home Health | 2449 45th St, Suite D, Highland, IN 46322 | 2012-01-23 |
| 1891926531 | Saket B Sinha | Internal Medicine | 9030 Cline Ave, Highland, IN 46322 | 2009-07-29 |
| 1194998963 | Affordable Hearing Aid Center | Hearing Instrument Specialist | 2148 45th St, Highland, IN 46322 | 2008-04-11 |
| 1497954390 | Highland Clinic of Northwest Indiana Inc | General Practice | 2834 Highway Ave Ste 1, Highland, IN 46322 | 2007-07-12 |
| Find all providers in zip 46322 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275032799 | Marianne Mann | Internal Medicine | 7105 Biter Lane, Highland, MD 20777 | 2018-02-10 |
| 1154702769 | Castlebridge Medical Associates, LLC | Internal Medicine | 12975 Highland Rd, #407, Highland, MD 20777-7500 | 2015-06-10 |
| 1437481082 | Catherine C Ciantar | Internal Medicine | 2330 S Milford Rd, Highland, MI 48357-4982 | 2010-02-08 |
| 1891926531 | Saket B Sinha | Internal Medicine | 9030 Cline Ave, Highland, IN 46322 | 2009-07-29 |
| 1861621575 | Agusti Medical Corporation | Internal Medicine | 9803 Prairie Ave, Highland, IN 46322-3633 | 2009-07-02 |
| 1457542292 | American Association of Visiting Physicians | Internal Medicine | 2834 Highway Ave, Highland, IN 46322-1629 | 2007-08-07 |
| 1649490723 | Barber Co | Internal Medicine | 210 West Highland, Suite 102, Highland, MI 48357-4573 | 2007-04-30 |
| 1497824304 | George Woody Jackson | Internal Medicine | 1440 Highway 62 412, Highland, AR 72542-9497 | 2006-11-06 |
| 1528147444 | Loren Jay Chassels | Internal Medicine | 801 Main St 442, Highland, IL 62249 | 2006-11-02 |
| 1518054352 | Mary Tilak | Internal Medicine | 2241 45th St, Highland, IN 46322-2601 | 2006-10-05 |
| Find all providers in HIGHLAND | ||||
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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.