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INTERNAL MEDICINEGERIATRICS AND ONCOLOGY GROUP P.C. NPI 1417983537


NPI Information

NPI: 1417983537
Provider Name: INTERNAL MEDICINE,GERIATRICS AND ONCOLOGY GROUP, P.C.

Former Legal Business Name: SHREYAS A. DESAI, M.D.

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 15D0912981

Address:
2640 HAMSTROM RD
PORTAGE, IN
ZIP 46368
Phone: (219) 762-9523
Get Directions

INTERNAL MEDICINE,GERIATRICS AND ONCOLOGY GROUP, P.C. is an internal medicine in Portage, IN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. INTERNAL MEDICINE,GERIATRICS AND ONCOLOGY GROUP, P.C. NPI is 1417983537. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Shreyas A. Desai, M.d..

The provider's business location address is:

2640 HAMSTROM RD
PORTAGE, IN
ZIP 46368-832
Phone: (219) 762-9523
Fax: (219) 763-3120

The provider's authorized official is Diana G Neumann .
The authorized official title is Billing Clerk and has the following contact phone number (219) 464-4786.

The CLIA number assigned to this NPI record is 15D0912981 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 7/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine01027933AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200201230MEDICAIDINDIANA
2234810AMEDICARE PININDIANA
3C25010MEDICARE UPININDIANA
4100157480AMEDICAIDINDIANA
5235780AMEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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