Provider Demographics
NPI:1407037260
Name:RESPIRATORY SLEEP ASSOCIATES, PC
Entity Type:Organization
Organization Name:RESPIRATORY SLEEP ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRETTONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-662-3931
Mailing Address - Street 1:PO BOX 1104
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46308-1104
Mailing Address - Country:US
Mailing Address - Phone:219-836-2449
Mailing Address - Fax:219-836-2953
Practice Address - Street 1:7550 HOHMAN AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1060
Practice Address - Country:US
Practice Address - Phone:219-836-2449
Practice Address - Fax:219-836-2953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047404A207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000544214OtherBLUE CROSS BLUE SHIELD
IL0090001354OtherBCBS IL
IN200893750AOtherMEDICAID GROUP ID
INDH0026OtherMEDICARE RAILROAD
INDH0026OtherMEDICARE RAILROAD