DR MARY TILAK PC
NPI 1003096900
Internal Medicine - Obesity Medicine in Munster, IN
About Dr Mary Tilak Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR MARY TILAK PC (NPI 1003096900) is a healthcare organization registered as an obesity medicine in Munster, Indiana and active in the NPI registry since November 2007. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Mary N. Tilak, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr Mary Tilak Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Dr Mary Tilak PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 3
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 15D2339231
Mary Tilak PC · Crown Point, INCertificate of Waiver 15D1035173
Dr Mary Tilak PC · Munster, INCertificate of Waiver 15D2021147
Dr Mary Tilak PC · Crown Point, INFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dr Mary Tilak PC's NPI number?
The NPI number for Dr Mary Tilak PC is 1003096900. It was assigned to this organization in the NPPES registry on November 7, 2007.
Where is Dr Mary Tilak PC located?
Dr Mary Tilak PC is located at 9410 Calumet Ave Ste 101, Munster, IN 46321. The listed phone number is (219) 922-8051.
What is Dr Mary Tilak PC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.
Is Dr Mary Tilak PC enrolled in Medicare?
Yes. Dr Mary Tilak PC is registered in the Medicare PECOS enrollment system.
When is Dr Mary Tilak PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dr Mary Tilak PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Dr Mary Tilak PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4), Family Practice (3) and Internal Medicine (2). Of these, 3 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Dr Mary Tilak PC hold CLIA laboratory certificates?
Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Dr Mary Tilak PC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Dr Mary Tilak PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Dr Mary Tilak PC was last updated on April 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr Mary Tilak Pc · NPI 1003096900
Obesity Medicine organization in Munster, Indiana. Organization record, active in the CMS NPPES registry since November 7, 2007.
## Identity
- **NPI:** 1003096900 (Entity type: Organization)
- **Enumerated:** November 7, 2007
- **Primary specialty:** Internal Medicine - Obesity Medicine · taxonomy 207RB0002X
- **Organization subpart:** No
- **Authorized official:** Mary Tilak, PRESIDENT
## Practice location
- **Address:** 9410 CALUMET AVE STE 101, Munster, IN 46321-2812
- **Phone:** (219) 922-8051 · **Fax:** (219) 922-8608
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Indiana, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 9 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Family Practice (3), Internal Medicine (2); 3 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 24, 2026
- **Other identifiers:** Other 000000541656 (IN); Other 90001352 (IL)
- **CLIA laboratory certificates:** 3 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003096900) · Data from the CMS NPPES public registry.