Unknown Individual – Family Medicine Physician, NPI 1801873435
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
611 S MARSHALL AVE
MC LEANSBORO, IL 628591213
Phone: (618) 643-2361
Fax: (618) 643-5565
Type: Location
401 NEWPORT BLVD
LA PORTE, IN 463504099
Phone: (219) 326-1775
Fax: (219) 326-1951
Type: Mailing
2022, Kelle Drive, Chesterton, Porter County, Indiana, 46304, United States
CHESTERTON, IN 463048708
Phone: (219) 364-3616
Fax: (219) 364-3610
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 67 Open Payments records for all available years, with a total value of $1,457.
Total Amount is formed as General ($1,457) + Research ($0) + Ownership ($0) = $1,457.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Novo Nordisk Inc ($145).
Total Amount
$1,457
General + Research + Ownership
Payments
67
Total payment records
General Amount
$1,457
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $145 |
| Boston Scientific Corporation | $145 |
| ABBVIE INC. | $142 |
| PFIZER INC. | $140 |
| Janssen Pharmaceuticals, Inc | $125 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 457 | 258 | $0 |
| 83036 | Hemoglobin a1c level | 195 | 102 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 166 | 126 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 131 | 131 | $0 |
| G0008 | Administration of influenza virus vaccine | 40 | 40 | $0 |
Insurance plans in this area (ZIP 62859)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IL | 85610 | Blood test, clotting time | 58 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Physician Assistant | IN | |
| - | IN | |
| - | IN | |
| Interventional Cardiology | PA |
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