St Vincent Pediatric Subspecialties

Key facts

NPI: 1013967736
Entity type: Organization (NPI type 2)
Primary specialty: Pediatrics Physician 208000000X
License: 050050751 (IN)
Legal business name: ST VINCENT PEDIATRIC SUBSPECIALTIES
Practice address: 2001 W 86TH St
Indianapolis, IN 46260-1902
Phone: (317) 338-2273
NPI assigned: May 11, 2006
Organization subpart: Yes
Parent organization (as reported): ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC

Authorized official

Name: Kevin McAndrews
Title: Vice President
Phone: (317) 583-3194

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

St Vincent Pediatric Subspecialties Pediatric Critical Care Medicine Physician · Evansville, IN · NPI 1851950224

Same enrollment O20050214000627

Practitioners 364

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Lynn Alkhatib Pediatrics Physician · Indianapolis, IN · NPI 1609404441

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Kelly Joann Barton, MD Pediatrics Physician · Indianapolis, IN · NPI 1851950729

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Margaret Burke, FNP-C Pediatric Nurse Practitioner · Indianapolis, IN · NPI 1144049545

Medicare reassignment Care Compare group NPD IN
Loraine Ruth Condrey, APRN Pediatric Nurse Practitioner · Indianapolis, IN · NPI 1043622533

Medicare reassignment Care Compare group NPD IN
Rachel Kochert Dunn, MD Pediatric Gastroenterology Physician · Indianapolis, IN · NPI 1649569419

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Monica Vermani Durr, APRN Pediatric Nurse Practitioner · Indianapolis, IN · NPI 1538667076

Medicare reassignment Care Compare group NPD IN
Luis Fernando Escobar, MD Clinical Genetics (M.D.) Physician · Indianapolis, IN · NPI 1053396135

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Jessica F Goodman, MD Pediatric Hematology & Oncology Physician · Indianapolis, IN · NPI 1831112093

Medicare reassignment Care Compare group NPD IN · PEDIATRIC HEMATOLOGY-ONCOLOGY
Jessica Nell Green, MD Pediatric Neurodevelopmental Disabilities Physician · Indianapolis, IN · NPI 1578604773

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Brooke Katherine Greene, MD Pediatrics Physician · Indianapolis, IN · NPI 1013593680

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Ronda Alazan Hamaker, MD Pediatric Otolaryngology Physician · Indianapolis, IN · NPI 1174572184

Medicare reassignment Care Compare group NPD IN · PEDIATRIC OTOLARYNGOLOGY
Jill McCaulley, M.D. Maternal & Fetal Medicine Physician · Indianapolis, IN · NPI 1669607388

Medicare reassignment Care Compare group NPD IN · MATERNAL & FETAL MEDICINE
Lisa M McGuire, MD Neurology with Special Qualifications in Child Neurology Physician · Indianapolis, IN · NPI 1790802064

Medicare reassignment Care Compare group NPD IN
Daniel W McKenney, MD Pediatric Nephrology Physician · Indianapolis, IN · NPI 1215911201

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
June C Murphy, DO Maternal & Fetal Medicine Physician · Indianapolis, IN · NPI 1912933771

Medicare reassignment Care Compare group NPD IN · MATERNAL & FETAL MEDICINE
Julia Kathrin O'Hara, CPNP, CPN, CPHON Pediatric Nurse Practitioner · Indianapolis, IN · NPI 1912370636

Medicare reassignment Care Compare group NPD IN
Michelle Yvette Owens, MD Maternal & Fetal Medicine Physician · Indianapolis, IN · NPI 1669694063

Medicare reassignment Care Compare group NPD IN · MATERNAL & FETAL MEDICINE
James C Pappas, MD Neurology with Special Qualifications in Child Neurology Physician · Indianapolis, IN · NPI 1710928148

Medicare reassignment Care Compare group NPD IN
Bassem I Razzouk, MD Pediatric Hematology & Oncology Physician · Indianapolis, IN · NPI 1124021829

Medicare reassignment Care Compare group NPD IN · PEDIATRIC HEMATOLOGY-ONCOLOGY
Elizabeth Ann Schaefer, MD Pediatric Gastroenterology Physician · Indianapolis, IN · NPI 1174652382

Medicare reassignment Care Compare group NPD IN
Macie Dane Snowden, RD Registered Dietitian · Indianapolis, IN · NPI 1013586585

Medicare reassignment Care Compare group NPD IN
Elizabeth Spiwak, MD Pediatric Nephrology Physician · Indianapolis, IN · NPI 1235524182

Medicare reassignment Care Compare group NPD IN
Eric E Tibesar, MD Pediatric Gastroenterology Physician · Indianapolis, IN · NPI 1659527786

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Bradley T Tinkle, M.D. Clinical Genetics (M.D.) Physician · Indianapolis, IN · NPI 1831120229

Medicare reassignment Care Compare group NPD IN · PEDIATRICS
Kira Elouise White, AU.D. Audiologist · Indianapolis, IN · NPI 1588460935

Medicare reassignment Care Compare group NPD IN

View all 364

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20050214000627	IN	Part B Supplier - Clinic/Group Practice	1557313939	Receives reassigned benefits from 305 practitioners 1 other NPI on this enrollment Practice locations: Indianapolis, IN; Carmel, IN; Kokomo, IN; Lafayette, IN; Lebanon, IN; Washington, IN; Zionsville, IN; Avon, IN…

National Provider Directory

Part of: Fred Sanders MD PC

Locations

7782 Solution Ctr
Chicago, IL 60677

10330 N Meridian St
Ste 300
Carmel, IN 46290

10330 N Meridian St
Ste 201
Carmel, IN 46290
Phone (317) 338-6234

301 E Carmel Dr
Carmel, IN 46032
Phone (317) 548-1483

11725 Illinois St
Ste 335
Carmel, IN 46032

3900 Washington Ave
Ste PMCH100
Evansville, IN 47714

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

11201 USA Pkwy
Ste 355
Fishers, IN 46037

13861 Olio Rd
#105
Fishers, IN 46037

8402 Harcourt Rd
Ste 320
Indianapolis, IN 46260
Phone (317) 338-2487

8081 Township Line Rd
#23
Indianapolis, IN 46260

8402 Harcourt Rd
Ste 300
Indianapolis, IN 46260
Phone (317) 338-3100

1717 W 86th St
Indianapolis, IN 46260

8333 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-3103

4740 Kingsway Dr
Indianapolis, IN 46205
Phone (317) 466-2001

8414 Naab Rd
Ste 205
Indianapolis, IN 46260
Phone (317) 338-8943

2705 N Lebanon St
Ste 405
Lebanon, IN 46052
Phone (765) 485-8444

60160 Bodnar Blvd
Mishawaka, IN 46544
Phone (574) 247-2790

10801 N Michigan Rd
Ste 240
Zionsville, IN 46077
Phone (317) 558-0630

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Orthodontics and Dentofacial Orthopedics Dentistry Group: 193200000X MULTI-SPECIALTY GROUP	1223X0400X
Maternal & Fetal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207VM0101X
Pediatric Orthopaedic Surgery Physician Group: 193200000X MULTI-SPECIALTY GROUP	207XP3100X
Pediatric Otolaryngology Physician Group: 193200000X MULTI-SPECIALTY GROUP	207YP0228X
Pediatrics Physician Group: 193200000X MULTI-SPECIALTY GROUP	208000000X	050050751	IN	Yes
Pediatric Adolescent Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080A0000X
Neonatal-Perinatal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080N0001X
Pediatric Cardiology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080P0202X
Pediatric Endocrinology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080P0205X
Pediatric Hematology & Oncology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080P0207X
Pediatric Pulmonology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2080P0214X
Physical Medicine & Rehabilitation Physician Group: 193200000X MULTI-SPECIALTY GROUP	208100000X
Pediatric Surgery Physician Group: 193200000X MULTI-SPECIALTY GROUP	2086S0120X
Hospitalist Physician Group: 193200000X MULTI-SPECIALTY GROUP	208M00000X
Nurse Practitioner Group: 193200000X MULTI-SPECIALTY GROUP	363L00000X

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

10330 N Meridian St
Suite 201
Indianapolis, IN 46290-1024

Other identifiers

Identifier	Type	State
200505130P	Medicaid	IN
200901000B	Medicaid	IN
200505130M	Medicaid	IN
200505130S	Medicaid	IN
200505130U	Medicaid	IN
200505130Y	Medicaid	IN
200505130I	Medicaid	IN
200505130C	Medicaid	IN
200505130J	Medicaid	IN
200505130R	Medicaid	IN
200505130V	Medicaid	IN
200505130X	Medicaid	IN
200505130E	Medicaid	IN
200505130F	Medicaid	IN
200505130K	Medicaid	IN
200505130L	Medicaid	IN
200505130O	Medicaid	IN
200505130H	Medicaid	IN
200505130N	Medicaid	IN
200505130W	Medicaid	IN
2602026	Medicaid	OH
200505130B	Medicaid	IN
200505130D	Medicaid	IN
200505130T	Medicaid	IN
200505130Z	Medicaid	IN
200901000A	Medicaid	IN
200505130A	Medicaid	IN
200505130G	Medicaid	IN
200505130Q	Medicaid	IN
200901000C	Medicaid	IN
2645178	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 17, 2014.

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    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1013967736",
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        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
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            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT PEDIATRIC SUBSPECIALTIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC",
        "enumeration_date": "2006-05-11",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "MCANDREWS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
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        {
            "code": "2080P0202X",
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        {
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            "license": null,
            "primary": false
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        {
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            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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}

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Pediatrics Physician in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.