Unknown Individual – Family Medicine Physician, NPI 1790790657
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
8315, Virginia Street, Merrillville, Ross Township, Lake County, Indiana, 46410, United States
STE M
MERRILLVILLE, IN 464109201
Phone: (219) 736-1500
Fax: (219) 736-1551
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)
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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.
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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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 43 | 25 | $0 |
Insurance plans in this area (ZIP 46410)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN |
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