Individual provider Active NPI

Mohannad Moallem, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1003026501
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01086945A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 274-4779
Fax
(317) 948-9806
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 01086945A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other practice location 1

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

Other identifiers 2

IdentifierTypeStateIssuer
300057674MedicaidIN
0050048MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110815000288 OH Practitioner - Pediatric Medicine 2860661527 Reassigns benefits to 1 organization
I20220204001474 IN Practitioner - Pediatric MedicinePractitioner - Sports Medicine 2860661527 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Feb 1, 2022 Accepting new patients
Blanchard Valley Regional Health Center Current Accepting new patients
Iu Health Medical Group Riley Specialists, LLC CurrentSince Jan 1, 2026 Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Oct 7, 2012 Accepting new patients
Blanchard Valley Regional Health Center Hospitalist CurrentSince Oct 7, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Feb 1, 2022 Accepting new patients
Pediatric Academic Association, Inc. CurrentSince Jul 1, 2011 Accepting new patients
University Pediatric Associates, Inc. PastSince Dec 21, 2021 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

11725 Illinois St
Ste 450
Carmel, IN 46032
Phone (317) 688-5700

11725 Illinois St
Ste 240
Carmel, IN 46032
Phone (317) 814-4590

11590 N Meridian St
Ste 300
Carmel, IN 46032
Phone (317) 944-8906

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

1400 N Ritter Ave
Ste 431
Indianapolis, IN 46219
Phone (317) 355-3090

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Dept L289
Columbus, OH 43260

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

Interoperability endpoints

  • Direct secure messaging: mmoallem512045@ecommunitydirect.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1003026501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-274-4779",
            "fax_number": "317-948-9806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7150 Clearvista Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561695",
            "country_code": "US",
            "telephone_number": "317-621-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOALLEM",
        "first_name": "MOHANNAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01086945A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300057674",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050048",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.