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NPI Code Detail

MEDICARE: SHALOM HEALTH CARE CENTER, INC.

MEDICARE: SHALOM HEALTH CARE CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician
2363LP0200XPediatric Nurse Practitioner
3363LF0000XFamily Nurse Practitioner
4207Q00000XFamily Medicine Physician
5363AM0700XMedical Physician Assistant
6207R00000XInternal Medicine Physician
7363A00000XPhysician Assistant
82084P0800XPsychiatry Physician
9261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992924633
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHALOM HEALTH CARE CENTER, INC.
Provider Business Mailing Address
First Line : 3400 LAFAYETTE ROAD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Provider Business Practice Location Address
First Line : 3400 LAFAYETTE ROAD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : LEONARDO R ORTEGA
Credential : M.D., M.P.H.
Telephone Number : 317-291-7422
Provider Enumeration Date : 04/24/2007
Last Update Date : 03/30/2026

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Directions to “SHALOM HEALTH CARE CENTER, INC. ” Practice Location

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