Individual provider Active NPI

Benjamin Michael Kline, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1023081593
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001483A Issued in IN
Practice address
1801 N Senate Blvd
Suite 535
Indianapolis, IN 46202-1228
Phone
(317) 963-1950
Fax
(317) 963-1955
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 002388 OH
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 10001483A IN Primary

Addresses

Primary practice location

1801 N Senate Blvd
Suite 535
Indianapolis, IN 46202-1228

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkline1@direct.iuhealth.org

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
I20130412000615 IN Practitioner - Physician Assistant 1052557261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002388OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc. CurrentSince Dec 1, 2012 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

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

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: bkline1@direct.iuhealth.org

Organizations & group practices 4

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1023081593",
    "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": "1801 N SENATE BLVD",
            "address_2": "SUITE 535",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021228",
            "telephone_number": "317-963-1950",
            "fax_number": "317-963-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "002388",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001483A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkline1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1801 N Senate Blvd",
            "address_2": "Suite 535",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.