LEE M PERIOLAT (MD) – Psychiatry Physician, NPI 1417974072

LEE M PERIOLAT (MD) is a healthcare provider. based in Valparaiso, Indiana. specializing in Psychiatry Physician. They hold the professional credentials MD. They hold a License No. 01026484 (IN). The NPI Number for LEE M PERIOLAT (MD) is 1417974072

Main info

Male
Sole Proprietor
57 Years Of Experience
Accepts Medicare Assignment
Name
LEE M PERIOLAT (MD)
NPI
1417974072
Phone
(219) 531-3662
Address
601 WALL ST
Enumeration Date
17 July 2006
Last Update Date
25 November 2020

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5747724040
Graduation Year
1969 (57 years ago)
PAC ID
3678748399
Group Practice PAC ID
1951293554
Professional Enrollment ID
I20111208000199

Contacts

Secure Messaging
lperiolat@porterstarke.direct.smartcarenet.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

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Provider Addresses for LEE M PERIOLAT (MD)

  • 601, Wall Street, Valparaiso, Porter County, Indiana, 46383, United States

    VALPARAISO, IN 463832512

    Phone: (219) 531-3662

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111208000199IPsychiatryINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46383)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951293554View full group profile
NameSpecialtyState
P S Y C H I A T R YIN
Mental Health CounselorIN
Clinical PsychologistIL
Mental Health CounselorIL
Nurse PractitionerIN
Mental Health CounselorIN
P S Y C H I A T R YMD
Nurse PractitionerIN
Nurse PractitionerIN
Clinical Social WorkerIN

Reviews

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Frequently asked questions

Does LEE M PERIOLAT (MD) have a public NPI I can cite?
Public records show LEE M PERIOLAT (MD) under NPI 1417974072.
Is LEE M PERIOLAT (MD) currently accepting referrals based on NPI status?
Registry metadata lists LEE M PERIOLAT (MD) as active.
What does the directory say LEE M PERIOLAT (MD) does?
Insurance directories may phrase it differently, but here LEE M PERIOLAT (MD) maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is LEE M PERIOLAT (MD) tied to Valparaiso, Indiana?
If you are local to Valparaiso, Indiana, LEE M PERIOLAT (MD) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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