| Leonard Buccellato, MD | |
| 
					761 45th St, Ste 108, Munster, IN 46321-2893  | |
| (219) 922-5416 | |
| (219) 922-3745 | 
| Full Name | Leonard Buccellato | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine - Pulmonary Disease | 
| Location | 761 45th St, Munster, Indiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1437198348 | NPI | - | NPPES | 
| M471400308 | Other | IN | MEDICARE PTAN | 
| 200493840 | Medicaid | IN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207RP1001X | Internal Medicine - Pulmonary Disease | 01058760 (Indiana) | Primary | 
| Entity Name | Permanente Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Leonard Buccellato, MD 1040 Sierra Dr Ste 400, Greenwood, IN 46143-7241 Ph: (317) 528-4800  | Leonard Buccellato, MD 761 45th St, Ste 108, Munster, IN 46321-2893 Ph: (219) 922-5416  | 
Maali Milhem, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 9126 Columbia Ave, Munster, IN 46321 Phone: 219-703-2408 Fax: 219-703-6684  | |
Sahar Halabi, M.D Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 761 45th St Ste 108, Munster, IN 46321 Phone: 219-922-5416 Fax: 219-922-3745  | |
Wassim Shwaiki, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 8840 Calumet Ave Ste 203, Munster, IN 46321 Phone: 219-836-7723 Fax: 219-836-7726  | |
Thottathil Viswanathan Gopan, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 761 45th St Ste 110, Munster, IN 46321 Phone: 219-922-3020 Fax: 219-922-3023  | |
Ammar Hassan, D.O. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 9410 Calumet Ave Ste 401, Munster, IN 46321 Phone: 219-922-4900 Fax: 219-836-9922  | |
Dr. Kyle Kleist, D.O. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 701 Superior Ave, Munster, IN 46321 Phone: 219-852-1524 Fax: 219-933-2288  | |
Dr. Gene Lee Chang, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 9030 Columbia Ave, Munster, IN 46321 Phone: 219-836-6002 Fax: 219-836-6003  |