Midwest Interventional Spine Specialists,LLC – Pain Medicine Physician, NPI 1962401745
Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Midwest Interventional Spine Specialists,LLC
7951 SHOAL CREEK BLVD STE 300
AUSTIN, TX 787577582
Phone: (512) 584-8404
Type: Mailing
8840 CALUMET AVE STE 103
MUNSTER, IN 463212546
Phone: (219) 836-7246
Fax: (219) 836-6454
Type: Location
1100 S Calumet Rd
Chesterton, IN 463043275
Phone: (219) 836-7246
Fax: (219) 836-6454
Type: Location
24 Joliet St
Dyer, IN 463111705
Phone: (219) 836-7246
Fax: (219) 836-6454
Type: Location
8840, Calumet Avenue, Munster, Lake County, Indiana, 46321, United States
SUITE 103
MUNSTER, IN 463212529
Phone: (219) 836-7246
Fax: (219) 836-6454
Type: Mailing
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: 2011-01-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (251 days ago).
Enrollment records
2
Earliest due date
2025-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040112000257 | O | Clinic/Group Practice | IN | 2025-09-30 |
| O20110121001002 | O | Physician - Interventional Pain Management | IN | 2026-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 78757)
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