| Vivek Mishra, MD | |
|
1007 Lincolnway, Laporte, IN 46350-2301 | |
| (219) 326-2305 | |
| (219) 326-2605 |
| Full Name | Vivek Mishra |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 34 Years |
| Location | 1007 Lincolnway, Laporte, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255356085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 01060036 (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Health - Porter | Valparaiso, IN | Hospital |
| St Mary Medical Center Inc | Hobart, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Vein Associates Of Northwest Indiana Llc | 3072744002 | 3 |
| Radiologic Associates Of Northwest Indiana Pc | 5890754469 | 10 |
| Entity Name | Radiologic Associates Of Northwest Indiana Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235186867 PECOS PAC ID: 5890754469 Enrollment ID: O20041008000285 |
| Entity Name | Vein Associates Of Northwest Indiana Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801217856 PECOS PAC ID: 3072744002 Enrollment ID: O20140314001944 |
| Entity Name | Midwest Innovative Pain Management Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487239067 PECOS PAC ID: 7113334004 Enrollment ID: O20210319001339 |
| Mailing Address | Practice Location Address |
|---|---|
| Vivek Mishra, MD 1007 Lincolnway, Laporte, IN 46350-2301 Ph: (219) 326-2305 | Vivek Mishra, MD 1007 Lincolnway, Laporte, IN 46350-2301 Ph: (219) 326-2305 |
Smari Thordarson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1007 Lincolnway, Laporte, IN 46350 Phone: 219-326-2305 Fax: 219-326-2605 | |
Hester J W Muller, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1007 Lincolnway, Laporte, IN 46350 Phone: 219-326-2305 Fax: 219-326-2605 |