Edgewater Health: Lake Street Pediatrics - Medicare Primary Care in Gary, IN

Edgewater Health: Lake Street Pediatrics is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Gary, Indiana. The current practice location for Edgewater Health: Lake Street Pediatrics is 426 S Lake St, Gary, Indiana. For appointments, you can reach them via phone at (219) 939-6070. The mailing address for Edgewater Health: Lake Street Pediatrics is 1100 W 6th Ave, Gary, Indiana and phone number is (219) 885-4264.

Edgewater Health: Lake Street Pediatrics is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1245907344. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (219) 939-6070.

Contact Information

Edgewater Health: Lake Street Pediatrics
426 S Lake St
Gary
IN 46403-2405
(219) 939-6070
Not Available

Primary Care Clinic Profile

Full NameEdgewater Health: Lake Street Pediatrics
SpecialityClinic/Center
Location426 S Lake St, Gary, Indiana
Authorized Official Name and PositionDanita Johnson Hughes (CEO)
Authorized Official Contact2198854264
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Edgewater Health: Lake Street Pediatrics
1100 W 6th Ave
Gary
IN 46402-1711

Ph: (219) 885-4264
Edgewater Health: Lake Street Pediatrics
426 S Lake St
Gary
IN 46403-2405

Ph: (219) 939-6070

NPI Details:

NPI Number1245907344
Provider Enumeration Date08/26/2021
Last Update Date08/26/2021

Medicare PECOS Information:

Medicare PECOS PAC ID9234398397
Medicare Enrollment IDO20210902000571

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Medical Identifiers

Medical identifiers for Edgewater Health: Lake Street Pediatrics such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245907344NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

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