DR. JASON MICHAEL PETRUNGARO (NPI# 1871765057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871765057 |
| Entity Type | Individual |
| Full Name | DR. JASON MICHAEL PETRUNGARO |
| Credential | M.D. |
| Practice Address |
800 Macarthur Blvd Suite 21 Munster IN 46321-2917 |
| Practice Telephone | 2198361163 |
| Practice Fax Number | 8442706677 |
| Mailing Telephone | 2198361163 |
| Mailing Fax Number | 8442706677 |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2016-08-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
01074460A | IN | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
N9993 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 8DT481 | 01 |
| IN | IN2244001 | MEDICARE | 01 |
| IN | BCBS IN | 0914915 | 01 |
| IN | RR MEDICARE | P01602561 | 01 |
| Street Address |
800 MACARTHUR BLVD SUITE 21 |
| City | MUNSTER |
| State | IN |
| Zip Code | 46321-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900275 | Fairmeadows Pharmacy Inc | Pharmacy | 800 Macarthur Blvd, Munster, IN 46321-2985 | 2005-05-31 |
| 1255701538 | Nicole Elizabeth Hawkins | Nurse Practitioner | 800 Macarthur Blvd, Munster, IN 46321-2917 | 2015-09-30 |
| 1750694204 | Horizon Medical, LLC | Clinic/Center | 800 Macarthur Blvd, Suite # 7, Munster, IN 46321-2917 | 2010-07-26 |
| 1326360256 | Munster Medical Research Foundation, Inc. | Obstetrics & Gynecology | 800 Macarthur Blvd, Suite 6, Munster, IN 46321-2917 | 2010-02-19 |
| 1093971343 | Fred Adler, M.d., P.C. | Clinic/Center | 800 Macarthur Blvd, Suite 2, Munster, IN 46321-2917 | 2008-08-05 |
| 1942489307 | Rg Halum Jr Md Urology Inc | Specialist | 800 Macarthur Blvd, Suite 1, Munster, IN 46321-2917 | 2007-11-01 |
| 1821277286 | Richard J Peach | Optometrist | 800 Macarthur Blvd, Suite 10, Munster, IN 46321-2917 | 2007-11-01 |
| 1225168404 | Giragos Heart and Vascular Center | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 800 Macarthur Blvd, Suite 25, Munster, IN 46321-2917 | 2007-03-06 |
| 1356482798 | Richard J Peach Od Inc | Optometrist | 800 Macarthur Blvd, Suite 10, Munster, IN 46321-2917 | 2007-02-09 |
| 1265529879 | Ramon Gaylon Halum Jr. | Urology | 800 Macarthur Blvd, Suite I, Munster, IN 46321 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1467092668 | Barbara Armstrong-whitaker | Counselor | 8855 Columbia Ave, Munster, IN 46321 | 2020-01-15 |
| 1427537661 | Courtney Szydelko | Physical Therapist | 759 45th St Ste 202, Munster, IN 46321 | 2018-08-08 |
| 1407341787 | New Harvest Therapy Services, Inc. | Clinic/Center | 8124 Calumet Ave Ste B, Munster, IN 46321 | 2018-06-28 |
| 1043717945 | Region Eye Care LLC | Optometrist | 10413 Calumet Ave., Munster, IN 46321 | 2018-04-09 |
| 1003318122 | Jean M Nanos | Psychologist | 8124 Calumet Ave, Munster, IN 46321 | 2018-03-05 |
| 1841706330 | Avalon Marciniak | Speech-Language Pathologist | 1950 West 45th St., Munster, IN 46321 | 2017-12-19 |
| 1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
| 1457871774 | Shannon Nicole Riley | Behavior Technician | 8113 Howard Ave., Munster, IN 46321 | 2017-06-27 |
| 1679017313 | Infomedica | Internal Medicine | 10010 Donald S Powers Dr, Munster, IN 46321 | 2016-12-15 |
| Find all providers in zip 46321 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639577794 | Petrungaro Plastic Surgery, LLC | Surgery | 800 Macarthur Blvd Ste 21, Munster, IN 46321-2918 | 2014-12-05 |
| 1578517553 | Robert E Frank | Surgery | 931 Ridge Rd, Suite A, Munster, IN 46321-1755 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982050340 | Eric Pittelkow | Surgery | 545 Barnhill Drive Emerson Hall, Suite 232, Indianapolis, IN 46202 | 2016-05-04 |
| 1164654257 | Erin Weber | Surgery | 1801 N Senate Blvd Ste 525, Indianapolis, IN 46202-1253 | 2009-08-21 |
| 1801036132 | Sholar Center for Aesthetic Surgery | Surgery | 445 Cross Pointe Blvd., Suite 230, Evansville, IN 44715-4013 | 2009-02-26 |
| 1013164425 | Dawn M Burgess | Surgery | 2701 Lincoln Ave, Evansville, IN 47714-1627 | 2008-08-27 |
| 1669677142 | Jaime Marie Ranieri | Surgery | 8051 S Emerson Ave Ste 450, Indianapolis, IN 46237-8667 | 2007-06-15 |
| 1770708158 | Kimberly K Short | Surgery | 8455 Clearvista Place, Indianapolis, IN 46256-2419 | 2007-04-13 |
| 1780770255 | Belarmino T Frogozo | Surgery | 501 E Hospital Ln Ste 107, Terre Haute, IN 47802-4230 | 2006-10-04 |
| 1740223510 | Elizabeth A Grasee | Surgery | 12425 Old Meridian St, Suite #b1, Carmel, IN 46032-8724 | 2006-06-13 |
| 1558344697 | William A Wooden | Surgery | 260 Emerson Hall, 545 Barnhill Dr, Indianapolis, IN 46202-5200 | 2005-11-22 |
| 1881690790 | Jeffrey David Wagner | Surgery | 8040 Clearvista Pkwy, Ste 570, Indianapolis, IN 46256 | 2005-06-24 |
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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.