| Sandra R Gates-manna, NP | |
|
1509 State St, La Porte, IN 46350-3115 | |
| (219) 325-5434 | |
| (219) 325-7655 |
| Full Name | Sandra R Gates-manna |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 1509 State St, La Porte, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124396072 | NPI | - | NPPES |
| 201059520 | Medicaid | IN | |
| 000000758275 | Other | IN | ANTHEM BCBS |
| 151020006 | Other | IN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 28125285A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71003896A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Methodist Hospitals Inc | Gary, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Okolocha Medical Corp | 5597794834 | 4 |
| Entity Name | Okolocha Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902851330 PECOS PAC ID: 5597794834 Enrollment ID: O20050808000530 |
| Entity Name | Edgewater Systems For Balanced Living Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588705784 PECOS PAC ID: 9234398397 Enrollment ID: O20120308000405 |
| Entity Name | Northwest Indiana Occupational Pain And Wellness Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518398882 PECOS PAC ID: 1254558000 Enrollment ID: O20140819000770 |
| Entity Name | Gary City Urgent And Immediate Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164033676 PECOS PAC ID: 1052723483 Enrollment ID: O20201209001114 |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra R Gates-manna, NP Po Box 1690, La Porte, IN 46352-1690 Ph: (219) 326-2312 | Sandra R Gates-manna, NP 1509 State St, La Porte, IN 46350-3115 Ph: (219) 325-5434 |
Mrs. Jennifer Campbell, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1509 State Street, La Porte, IN 46350 Phone: 219-324-3431 Fax: 219-362-3802 | |
Tami Clinkenbeard, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 Newporte Blvd, La Porte, IN 46350 Phone: 219-326-1775 Fax: 219-326-1951 | |
Kimberly Minich, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 602 F St, La Porte, IN 46350 Phone: 219-324-1377 | |
Fabienne Fify, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1700 I St, La Porte, IN 46350 Phone: 708-288-5036 | |
April Donald, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 204 Legacy Plz W, La Porte, IN 46350 Phone: 219-476-7246 | |
Mrs. Tina Marie Pierce, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 809 Jefferson Ave, La Porte, IN 46350 Phone: 219-878-5645 |