Individual provider Active NPI

Michael A Litwiller, MD

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1033154067
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01036515A Issued in IN
Practice address
2620 Kessler Boulevard East Dr
Ste 210
Indianapolis, IN 46220-2890
Phone
(317) 475-6200
Fax
(317) 475-6212
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01036515 IN
Psychiatry Physician 2084P0800X 01036515A IN Primary

Addresses

Primary practice location

2620 Kessler Boulevard East Dr
Ste 210
Indianapolis, IN 46220-2890

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959
Phone (317) 962-3834

Other identifiers 2

IdentifierTypeStateIssuer
100176440AMedicaidIN
P00887152OtherINRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlitwiller@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090605000192 IN Practitioner - Psychiatry 1759431158 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01036515INMDPsychiatry Physician
01036515AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Mar 1, 2010 Accepting new patients
Major Hospital Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1115 Ronald Reagan Pkwy
Ste 364
Avon, IN 46123
Phone (317) 217-2636

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

9670 E Washington St
Ste 120
Indianapolis, IN 46229
Phone (317) 890-5700

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

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1033154067",
    "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",
            "telephone_number": "317-962-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 KESSLER BOULEVARD EAST DR",
            "address_2": "STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202890",
            "telephone_number": "317-475-6200",
            "fax_number": "317-475-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITWILLER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01036515",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01036515A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100176440A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00887152",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlitwiller@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2620 Kessler Boulevard East Dr",
            "address_2": "Ste 210",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462202890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.