NPIMap

State of Indiana Auditor of State

A Medicare group practice based in Indianapolis, IN: 12 NPIs enrolled under one PECOS associate control ID (PAC ID 1759280118), with 113 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
1759280118The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Hospital, Part A Provider - Skilled Nursing Facility, Part B Supplier - Clinic/Group Practice, Part B Supplier - Independent Clinical Laboratory, Part B Supplier - Mass Immunization (Roster Biller Only)
Enrolled in
IN
Enrollments
8
Group size
11 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
13In 6 places

Enrollment records 8

Enrollment IDStateProvider typeNPI
O20040105000564 IN Part B Supplier - Clinic/Group Practice 1700876224
O20080725000471 IN Part A Provider - Hospital 1174654305
O20110105000490 IN Part A Provider - Hospital 1700876224
O20110322000070 IN Part A Provider - Skilled Nursing Facility 1194778001
O20110308000199 IN Part A Provider - Hospital 1518060912
O20101004001331 IN Part A Provider - Hospital 1922094481
O20140801001493 IN Part B Supplier - Independent Clinical Laboratory 1194033092
O20201229000542 IN Part B Supplier - Mass Immunization (Roster Biller Only) 1023613403

NPIs in this group 12

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 113

Page 1 of 2

Clinicians who reassign their Medicare benefits to this group (113) or whom Care Compare lists as members (11).

Sources for this page