Individual provider Active NPI

Olivia Cecile Cabanban, PA

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1003456864
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002816A Issued in IN
Practice address
7525 E 82ND St Ste a
Indianapolis, IN 46256-1435
Phone
(317) 621-1670
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002816A IN Primary

Addresses

Primary practice location

7525 E 82ND St Ste a
Indianapolis, IN 46256-1435

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

2330 S Dixon Rd
Kokomo, IN 46902-6411
Phone (765) 455-5400

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL AHN Health Information Exchange (HIE)
Direct Messaging Address olivia.cabanbanpa.p7@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303002056 IN Practitioner - Physician Assistant 5395172324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

7525 E 82ND St
Indianapolis, IN 46256-1435

Hospital & facility affiliations

  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana, LLC CurrentSince Mar 1, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jun 1, 2024 Accepting new patients
American Health Network of Indiana LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

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

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

7525 E 82nd St
Ste A
Indianapolis, IN 46256
Phone (317) 621-1670

2330 S Dixon Rd
Kokomo, IN 46902
Phone (765) 455-5400

Interoperability endpoints

  • Direct secure messaging: ocabanban617303@ecommunitydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1003456864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 E 82ND ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561435",
            "telephone_number": "317-621-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 S Dixon Rd",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469026411",
            "country_code": "US",
            "telephone_number": "765-455-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABANBAN",
        "first_name": "OLIVIA",
        "middle_name": "CECILE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002816A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "AHN",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2330 S Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "olivia.cabanbanpa.p7@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccda",
            "address_1": "2330 S Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.