Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MARYLOU CERVANTES
NPI 1124948229
Nurse Practitioner - Family in Portage, IN

Q: What is Marylou Cervantes's NPI number?

The NPI number for Marylou Cervantes is 1124948229. It was assigned to this individual provider in the NPPES registry on July 17, 2026.

Q: What is Marylou Cervantes's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Marylou Cervantes was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 17, 2026PECOS Enrolled

6050 STERLING CREEK RD, PORTAGE, IN 46368(219) 763-8112 Get Directions Write a Review

NPPES record added: July 17, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Marylou Cervantes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYLOU CERVANTES (NPI 1124948229) is an individual family provider in Portage, Indiana, licensed in Indiana (71018351A) and active in the NPI registry since July 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124948229

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARYLOU CERVANTES

Location Address6050 STERLING CREEK RDPortage, IN 46368-7752

Mailing Address2665 Poplar StPortage, IN 46368-2940

Phone(219) 763-8112

Sole ProprietorNo

Enumeration DateJuly 17, 2026

NPPES CertifiedJuly 18, 2026

✔ NPI 1124948229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IN · 71018351A

6050 STERLING CREEK RD, Portage, IN 46368

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marylou Cervantes is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46368 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANA DAWNIELLE JONES MD

Obstetrics & Gynecology