Active NPI
Milie Fang, DO
- Dermatology Physician
- Indianapolis, IN
National Provider Identifier
1013530849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 02008988A
- Practice address
- 705 Riley Hospital Dr
Indianapolis, IN 46202-5109 - Phone
- (317) 948-3052
- NPI assigned
- May 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 02008988A | IN | Primary |
| Dermatology Physician | 207N00000X | PG215976 | OR | |
| Dermatology Physician | 207N00000X | DO.OP.61660584 | WA |
Addresses
Primary practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
3303 S Bond Ave Dept
Portland, OR 97239-4501
Phone (503) 494-1375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300130475 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MFANG@DIRECT.IUHEALTH.ORG | 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Marian University College of Osteopathic Medicine, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
250 N Shadeland Ave
Indianapolis, IN 46219-4959
5041 SW View Point Ter
Portland, OR 97239-3906
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02008988A | IN | MD | Dermatology Physician |
| PG215976 | OR | MD | Dermatology Physician |
| DO.OP.61660584 | WA | MD | Dermatology Physician |
Interoperability endpoints
- mfang@direct.iuhealth.org
Organizations & group practices 1
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1013530849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"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": "317-948-3052"
}
],
"practiceLocations": [
{
"address_1": "3303 S Bond Ave Dept",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972394501",
"country_code": "US",
"telephone_number": "503-494-1375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FANG",
"first_name": "MILIE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "02008988A",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "PG215976",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "DO.OP.61660584",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300130475",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MFANG@DIRECT.IUHEALTH.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "705 Riley Hospital Dr",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462025109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.