Individual provider Active NPI

Emily N Hrisomalos, MD

  • Otolaryngology Physician
  • Zionsville, IN
National Provider Identifier
1043578495
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01079923A Issued in IN
Practice address
1650 W Oak St Ste 107
Zionsville, IN 46077-3835
Phone
(317) 721-4190
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME132004 FL
Otolaryngology Physician 207Y00000X 132004 FL
Facial Plastic Surgery Physician 207YS0123X 01079923A IN
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 01079923A IN Primary

Addresses

Primary practice location

1650 W Oak St Ste 107
Zionsville, IN 46077-3835

Mailing address

1650 W Oak St Ste 107
Zionsville, IN 46077-3835
Phone (317) 721-4190

Other identifiers 1

IdentifierTypeStateIssuer
01079923AOtherINSTATE LICENSE

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
I20180815003026 IN Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 1052687027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1650 W Oak St
Zionsville, IN 46077-3835
Phone (317) 848-0001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132004FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Plastic Surgeons of Indiana PC CurrentSince Aug 1, 2018 Accepting new patients
Emily N Hrisomalos, MD LLC CurrentSince Dec 15, 2021 Accepting new patients
University of Miami Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

11455 N Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 796-7877

1650 W Oak St
Ste 107
Zionsville, IN 46077
Phone (317) 329-1615

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 1

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1043578495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W OAK ST STE 107",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460773835",
            "telephone_number": "317-721-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W OAK ST STE 107",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460773835",
            "telephone_number": "317-721-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRISOMALOS",
        "first_name": "EMILY",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME132004",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "132004",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "IN",
            "license": "01079923A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01079923A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "01079923A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

Verify at the official NPI Registry.