Indiana Sports & Medical Science Institute, PC
NPI 1609155290ActiveOrganization· Clinic/Center· Crown Point, IN
Clinic/Center in Crown Point, Indiana, registered in NPPES in August 2011. The authorized official on file is Timothy James Mullaly, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1609155290 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 12, 2011 |
| Last updated in NPPES | Jul 11, 2022 |
| Certified by provider | Jul 11, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 02003099A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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